Provider Demographics
NPI:1932432911
Name:CASTELLANOS, PAMELA F (LPCP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:F
Last Name:CASTELLANOS
Suffix:
Gender:F
Credentials:LPCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17255 OAK PARK AVE
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-3401
Mailing Address - Country:US
Mailing Address - Phone:708-633-4533
Mailing Address - Fax:708-633-4531
Practice Address - Street 1:17255 OAK PARK AVE
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-3401
Practice Address - Country:US
Practice Address - Phone:708-633-4533
Practice Address - Fax:708-633-4531
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-005799101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional