Provider Demographics
NPI:1720280084
Name:CASTILLO, VENANSIO (LPC)
Entity Type:Individual
Prefix:
First Name:VENANSIO
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8641
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-8641
Mailing Address - Country:US
Mailing Address - Phone:956-639-6038
Mailing Address - Fax:956-554-3070
Practice Address - Street 1:4969 N PASO DOBLE CIR
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-4043
Practice Address - Country:US
Practice Address - Phone:956-639-6038
Practice Address - Fax:956-554-3070
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19410101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional