Provider Demographics
NPI:1053467613
Name:CASTANEDA, ALMA GRACIELA (LPC)
Entity type:Individual
Prefix:MS
First Name:ALMA
Middle Name:GRACIELA
Last Name:CASTANEDA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 REMINGTON AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-3939
Mailing Address - Country:US
Mailing Address - Phone:956-483-4465
Mailing Address - Fax:
Practice Address - Street 1:2101 REMINGTON AVE
Practice Address - Street 2:SUITE B
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-3942
Practice Address - Country:US
Practice Address - Phone:956-483-4465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15325101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX027897001Medicaid