Basic Information
| Provider Information | |||||||||
| NPI: | 1205094448 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CASTRO | ||||||||
| FirstName: | KATIA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MISS | ||||||||
| NameSuffix: | |||||||||
| Credential: | M. ED. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9430 BOCA COVE CIRCLE #205 | ||||||||
| Address2: | |||||||||
| City: | BOCA RATON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33428 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616743060 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1639 FORUM PL | ||||||||
| Address2: | SUITE 7 | ||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334012330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617128821 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2008 | ||||||||
| LastUpdateDate: | 08/14/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YM0800X | MHI2317 | FL | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.