Provider Demographics
NPI:1568902849
Name:CASTILLO BECKETT, ROXANNE (MA, LPC-S)
Entity type:Individual
Prefix:
First Name:ROXANNE
Middle Name:
Last Name:CASTILLO BECKETT
Suffix:
Gender:
Credentials:MA, LPC-S
Other - Prefix:
Other - First Name:ROXANNE
Other - Middle Name:
Other - Last Name:CASTILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:29616 COPPER XING
Mailing Address - Street 2:
Mailing Address - City:BULVERDE
Mailing Address - State:TX
Mailing Address - Zip Code:78163-2499
Mailing Address - Country:US
Mailing Address - Phone:832-526-2369
Mailing Address - Fax:
Practice Address - Street 1:2021 GUADALUPE ST STE 260
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-5654
Practice Address - Country:US
Practice Address - Phone:832-526-2369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-06
Last Update Date:2025-04-14
Deactivation Date:2019-11-04
Deactivation Code:
Reactivation Date:2025-02-27
Provider Licenses
StateLicense IDTaxonomies
TX76197101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor