Provider Demographics
NPI:1841499977
Name:CALDERON-CASTRO, NYLSA IVETTE (LMHC)
Entity type:Individual
Prefix:
First Name:NYLSA
Middle Name:IVETTE
Last Name:CALDERON-CASTRO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 N FLAGLER DR STE 101
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3429
Mailing Address - Country:US
Mailing Address - Phone:561-642-1000
Mailing Address - Fax:561-804-5629
Practice Address - Street 1:2051 45TH ST STE 300
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2031
Practice Address - Country:US
Practice Address - Phone:561-642-1000
Practice Address - Fax:561-804-5629
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7219101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH7219OtherFL. LICENSE NUMBER