Individual provider Active NPI

Pablo Castro Jr., LAC, BHP

  • Professional Counselor
  • Tucson, AZ
National Provider Identifier
1598522476
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-23001 Issued in AZ
Practice address
2325 N Wyatt Dr
Tucson, AZ 85712-2121
Phone
(520) 616-1510
NPI assigned
Mar 6, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC-23001 AZ Primary
Professional Counselor 101YP2500X LAC-21119 AZ

Addresses

Primary practice location

2325 N Wyatt Dr
Tucson, AZ 85712-2121

Mailing address

PO Box 188
Marana, AZ 85653-0188
Phone (520) 682-4111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20240508002477 AZ Practitioner - Mental Health Counselor 1759722788 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LAC-21119AZMDProfessional Counselor
LPC-23001AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Escalera Health LLC CurrentSince Aug 16, 2024 Accepting new patients
Marana Health Center, Inc Past Accepting new patients

Locations

2224 N Craycroft Rd
Ste 100
Tucson, AZ 85712
Phone (520) 209-1919

2850 N Country Club Rd
Tucson, AZ 85716
Phone 52032262747104

6303 E Tanque Verde Rd
Ste 210
Tucson, AZ 85715
Phone (520) 423-5600

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1709683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1598522476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856530188",
            "telephone_number": "520-682-4111",
            "fax_number": "520-616-1442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 N WYATT DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122121",
            "telephone_number": "520-616-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTRO",
        "first_name": "PABLO",
        "name_suffix": "Jr.",
        "credential": "LAC, BHP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-06",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-23001",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LAC-21119",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.