Provider Demographics
NPI:1871911487
Name:GRACE CASTILLO LCSW, PLLC
Entity type:Organization
Organization Name:GRACE CASTILLO LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:512-426-1455
Mailing Address - Street 1:1311 CHISHOLM TRL
Mailing Address - Street 2:SUITE 301
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-2968
Mailing Address - Country:US
Mailing Address - Phone:512-426-1455
Mailing Address - Fax:
Practice Address - Street 1:1311 CHISHOLM TRL
Practice Address - Street 2:SUITE 301
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-2968
Practice Address - Country:US
Practice Address - Phone:512-426-1455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-01
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25468251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health