Provider Demographics
NPI:1700592110
Name:CASTILLO, AMELY (LLMSW)
Entity Type:Individual
Prefix:
First Name:AMELY
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:AMELY
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:N/A
Mailing Address - Street 1:2970 MOUNTAIN LION DR APT 107
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-8974
Mailing Address - Country:US
Mailing Address - Phone:580-861-2316
Mailing Address - Fax:
Practice Address - Street 1:2970 MOUNTAIN LION DR APT 107
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-8974
Practice Address - Country:US
Practice Address - Phone:810-295-1459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511153601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical