Individual provider Active NPI

Jose Lee Castillo III, LCSW

  • Mental Health Counselor
  • Palm Springs, CA
National Provider Identifier
1669982138
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
109624 Issued in CA
Practice address
777 E Tahquitz Canyon Way Ste 200-44
Palm Springs, CA 92262-6784
Phone
(760) 699-7888
Fax
(833) 907-1198
NPI assigned
Oct 10, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X 8090730-3506 UT
Clinical Social Worker 1041C0700X 109624 CA
Mental Health Counselor 101YM0800X 109624 CA Primary

Addresses

Primary practice location

777 E Tahquitz Canyon Way Ste 200-44
Palm Springs, CA 92262-6784

Mailing address

777 E Tahquitz Canyon Way Ste 200-44
Palm Springs, CA 92262-6784
Phone (760) 699-7888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20221013002133 CA Practitioner - Clinical Social Worker 0345616512 Practice locations: Palm Springs, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Utah School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1111 E Tahquitz Canyon Way
Suite 121
Palm Springs, CA 92262-0102
Phone (801) 900-7558

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8090730-3506UTMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Happy Homo CurrentSince May 15, 2023 Accepting new patients

Locations

777 E Tahquitz Canyon Way
Ste 20044
Palm Springs, CA 92262
Phone (760) 699-7888

1801 E Tahquitz Canyon Way
Ste 100
Palm Springs, CA 92262

1111 E Tahquitz Way
Ste 121
Palm Springs, CA 92262
Phone (760) 861-2591

Organizations & group practices 1

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": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1669982138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 E TAHQUITZ CANYON WAY STE 200-44",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922626784",
            "telephone_number": "760-699-7888",
            "fax_number": "833-907-1198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 E TAHQUITZ CANYON WAY STE 200-44",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922626784",
            "telephone_number": "760-699-7888",
            "fax_number": "833-907-1198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTILLO",
        "first_name": "JOSE",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-10",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "UT",
            "license": "8090730-3506",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "109624",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "109624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

Verify at the official NPI Registry.