Provider Demographics
NPI:1134885338
Name:CASTELLANOS, EMMANUEL (MS, LPC SAC-IT)
Entity type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:
Last Name:CASTELLANOS
Suffix:
Gender:M
Credentials:MS, LPC SAC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 WILSON AVE RM 330
Mailing Address - Street 2:
Mailing Address - City:MENOMONIE
Mailing Address - State:WI
Mailing Address - Zip Code:54751-2746
Mailing Address - Country:US
Mailing Address - Phone:715-256-7166
Mailing Address - Fax:888-427-8048
Practice Address - Street 1:4330 GOLF TER STE 209
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-4688
Practice Address - Country:US
Practice Address - Phone:715-256-7166
Practice Address - Fax:888-427-8048
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20405-130101YA0400X, 101YA0400X
WI11971-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)