Myra Clementine Castaneda, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

166.001321 Issued in IL

Practice address

5100 N Ravenswood Ave Ste 209
Chicago, IL 60640-1710

Phone

(773) 769-7204

NPI assigned

Jan 29, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1639700685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5011 N CALIFORNIA AVE APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253617",
            "telephone_number": "773-656-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 N RAVENSWOOD AVE STE 209",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401710",
            "telephone_number": "773-769-7204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTANEDA",
        "first_name": "MYRA",
        "middle_name": "CLEMENTINE",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-29",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166.001321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrian Daniel Castaneda, PHARMD
• Alicia Castaneda
• Andy Bryan Castaneda, MD
• Diana Castaneda, LCPC
• Leilani Castaneda
• Noemi Castaneda
• Marcela Castano
• Jonathan Castejon
• Laura Castelao, LCSW
• Ajith R Castelino, M.D.

• Marriage & Family Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Marriage & Family Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.