| Nicsam Behavioral Health | |
|
6057 Stone Wash St El Paso TX 79932-2147 | |
| (915) 257-9189 | |
| Not Available |
| Full Name | Nicsam Behavioral Health |
|---|---|
| Speciality | Social Worker |
| Location | 6057 Stone Wash St, El Paso, Texas |
| Authorized Official Name and Position | Diana Fabiola Castillo (PSYCHOTHERAPIST) |
| Authorized Official Contact | 9154747068 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nicsam Behavioral Health 6057 Stone Wash St El Paso TX 79932-2147 Ph: (915) 257-9189 | Nicsam Behavioral Health 6057 Stone Wash St El Paso TX 79932-2147 Ph: (915) 257-9189 |
| NPI Number | 1659076883 |
|---|---|
| Provider Enumeration Date | 04/05/2023 |
| Last Update Date | 04/05/2023 |
| Certification Date | 04/05/2023 |
| Medicare PECOS PAC ID | 5698132967 |
|---|---|
| Medicare Enrollment ID | O20230531002569 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659076883 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Diana Fabiola Castillo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154034957 PECOS PAC ID: 6305210097 Enrollment ID: I20230321000042 |
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