Individual provider Active NPI

Kimberly Castillo, LPC

  • Professional Counselor
  • Clifton, NJ
National Provider Identifier
1215508718
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
37PC01050300 Issued in NJ
Practice address
1451 Van Houten Ave
Clifton, NJ 07013-2432
Phone
(973) 473-2775
NPI assigned
Jul 6, 2021
Last updated
Jul 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 37PC01050300 NJ Primary

Addresses

Primary practice location

1451 Van Houten Ave
Clifton, NJ 07013-2432

Mailing address

595 Chestnut Ridge Rd FL 41
Woodcliff Lake, NJ 07677-7663
Phone (732) 982-2888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240813004410 NJ Practitioner - Mental Health Counselor 6800334467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New Jersey Behavioral Health PCGroup PAC ID 4284001025, 127 clinicians

Practice addresses (Care Compare)

595 Chestnut Ridge Rd
Suite 4
Woodcliff Lake, NJ 07677-7667
Phone (732) 982-2888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey Behavioral Health P.C CurrentSince Jul 29, 2024 Accepting new patients
PHC of Buffalo Grove Clinical Psychology Past Accepting new patients
Mental Health Clinic of Passaic Inc PastSince Jul 17, 2021 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

150 Morristown Rd
Ste 108
Bernardsville, NJ 07924
Phone (844) 259-2366

88 Princeton Hightstown Rd
Ste 202
West Windsor, NJ 08550
Phone (609) 497-3300

595 Chestnut Ridge Rd
Ste 4
Woodcliff Lake, NJ 07677
Phone (201) 391-2020

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/mhcp/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1215508718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 CHESTNUT RIDGE RD FL 41",
            "city": "WOODCLIFF LAKE",
            "state": "NJ",
            "postal_code": "076777663",
            "telephone_number": "732-982-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 VAN HOUTEN AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132432",
            "telephone_number": "973-473-2775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTILLO",
        "first_name": "KIMBERLY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-06",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC01050300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.