Provider Demographics
NPI:1093117319
Name:REYES-CASTILLO, CRYSTAL MARIA (LMHC)
Entity type:Individual
Prefix:MS
First Name:CRYSTAL
Middle Name:MARIA
Last Name:REYES-CASTILLO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:MARIA
Other - Last Name:REYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:8300 ESTERS BLVD STE 900
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-2233
Mailing Address - Country:US
Mailing Address - Phone:415-424-4266
Mailing Address - Fax:415-520-6633
Practice Address - Street 1:9100 S DADELAND BLVD STE 1500
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7816
Practice Address - Country:US
Practice Address - Phone:415-424-4266
Practice Address - Fax:415-520-6633
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12647101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health