Inner Bloom Professional Counseling Services LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

INNER BLOOM PROFESSIONAL COUNSELING SERVICES LLC

Practice address

19330 S 208TH PL
Queen Creek, AZ 85142-1615

Phone

(520) 517-8223

NPI assigned

Mar 12, 2025

Organization subpart

No

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

Authorized official

Name

Chantal Rose CastilloNPI 1851989651

Title

Owner/Manager

Phone

(520) 517-8223

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chantal Rose Castillo, LPC

  • Professional Counselor
  • Queen Creek, AZ
  • NPI 1851989651

  Mental Health

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1741737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741737600000",
    "number": "1316746357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19330 S 208TH PL",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851421615",
            "telephone_number": "520-517-8223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19330 S 208TH PL",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851421615",
            "telephone_number": "520-517-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER BLOOM PROFESSIONAL COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-12",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-11",
        "status": "A",
        "authorized_official_last_name": "CASTILLO",
        "authorized_official_first_name": "CHANTAL",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "520-517-8223"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.