Individual provider Active NPI

Amber Elise Castleschouldt

  • Psychiatric/Mental Health Nurse Practitioner
  • Willis, TX
National Provider Identifier
1386521979
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1209592 Issued in TX
Practice address
10672 FM 1097 Rd W
Willis, TX 77318-4909
Phone
(936) 259-2038
NPI assigned
Aug 18, 2025
Last updated
Aug 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1209592 TX Primary

Addresses

Primary practice location

10672 FM 1097 Rd W
Willis, TX 77318-4909

Mailing address

614 Ross St
La Marque, TX 77568-6123

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251022001906 TX Practitioner - Nurse Practitioner 9436647468 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

10672 FM 1097 Rd W
Willis, TX 77318-4909
Phone (936) 259-2038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1209592TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
A Balanced Mind Psychiatry Psychiatric/Mental Health CurrentSince Sep 2, 2025 Accepting new patients
Nueva Vida Behavioral Health Associates,Inc CurrentSince Sep 29, 2025 Accepting new patients

Locations

9500 Tioga Dr
Ste A
San Antonio, TX 78230
Phone (210) 616-0828

10672 FM 1097 Rd W
Willis, TX 77318
Phone (936) 259-2038

Organizations & group practices 2

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": "1755475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1386521979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 ROSS ST",
            "city": "LA MARQUE",
            "state": "TX",
            "postal_code": "775686123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10672 FM 1097 RD W",
            "city": "WILLIS",
            "state": "TX",
            "postal_code": "773184909",
            "telephone_number": "936-259-2038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTLESCHOULDT",
        "first_name": "AMBER",
        "middle_name": "ELISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-18",
        "last_updated": "2025-08-18",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1209592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willis, TX

Sources for this page

Verify at the official NPI Registry.