Provider Demographics
NPI:1952165284
Name:DE LA CASTRO, ERIKA ROSE (MFTC)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:ROSE
Last Name:DE LA CASTRO
Suffix:
Gender:F
Credentials:MFTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1675 DOVER ST
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-1365
Mailing Address - Country:US
Mailing Address - Phone:402-980-2696
Mailing Address - Fax:
Practice Address - Street 1:824 PINE ST STE 107
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1836
Practice Address - Country:US
Practice Address - Phone:402-980-2696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFTC.0014426106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist