Provider Demographics
NPI:1770319287
Name:CASTRO, RUBEN (LCSW)
Entity type:Individual
Prefix:
First Name:RUBEN
Middle Name:
Last Name:CASTRO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 E CONVENT ST
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-8235
Mailing Address - Country:US
Mailing Address - Phone:210-630-5918
Mailing Address - Fax:
Practice Address - Street 1:802 E CRESTWOOD DR
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-3309
Practice Address - Country:US
Practice Address - Phone:361-576-4673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX628561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical