Provider Demographics
NPI:1548041577
Name:CASTILLO, MICHELLE MENDOZA (LCSW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MENDOZA
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13804 N 37TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-0629
Mailing Address - Country:US
Mailing Address - Phone:956-330-4212
Mailing Address - Fax:
Practice Address - Street 1:13804 N 37TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-0629
Practice Address - Country:US
Practice Address - Phone:956-330-4212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1045751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical