Angie Botero Castro, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

13134 Issued in CT

Practice address

140 N Frontage Rd
Mansfield Center, CT 06250-1648

Phone

(860) 456-2261

Fax

(860) 450-1357

NPI assigned

Mar 16, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

United Services IncGroup PAC ID 8426042698, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• United Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dayville, CT
  • NPI 1063413011

  CT

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1841875366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 N MAIN ST",
            "city": "DAYVILLE",
            "state": "CT",
            "postal_code": "062412170",
            "telephone_number": "860-774-2020",
            "fax_number": "860-774-0826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 N FRONTAGE RD",
            "city": "MANSFIELD CENTER",
            "state": "CT",
            "postal_code": "062501648",
            "telephone_number": "860-456-2261",
            "fax_number": "860-450-1357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTERO CASTRO",
        "first_name": "ANGIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-16",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "5633",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "13134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayisha Bennett
• Scott R Berger, M.D.
• Susan Marie Blayer, LCSW, MDIV
• Jamie Leale Blodgett, LCSW
• Andrew Botelho, LPC-A
• Osman Botonjic
• Jenna Boulette, LCSW
• Kaitlyn Ann Bowyer, LMSW
• Stella Bragoni
• Zachary Brown, LMSW

• All providers in Mansfield Center, CT
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.