Individual provider Active NPI

Charrisa Castillo, LSCSW

  • Clinical Social Worker
  • Pittsburg, KS
National Provider Identifier
1881990208
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4449 Issued in KS
Practice address
107 N Pine St Ste B
Pittsburg, KS 66762-4757
Phone
(620) 249-3935
NPI assigned
Feb 2, 2011
Last updated
Jan 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4449 KS Primary

Addresses

Primary practice location

107 N Pine St Ste B
Pittsburg, KS 66762-4757

Mailing address

107 N Pine St Ste B
Pittsburg, KS 66762-4757
Phone (620) 249-3539

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20150612000487 KS Practitioner - Clinical Social Worker 7911218227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

107 N Pine St
Suite B
Pittsburg, KS 66762-4757
Phone (620) 249-3539

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brainpathway, LLC Clinical CurrentSince Feb 27, 2023 Accepting new patients

Locations

107 N Pine St
Ste B
Pittsburg, KS 66762
Phone (620) 249-3539

2809 N Broadway St
Ste 1
Pittsburg, KS 66762

2809 N Broadway St
Ste I
Pittsburg, KS 66762
Phone (620) 249-3539

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, 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": "1296604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1881990208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 N PINE ST STE B",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667624757",
            "telephone_number": "620-249-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N PINE ST STE B",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667624757",
            "telephone_number": "620-249-3935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTILLO",
        "first_name": "CHARRISA",
        "credential": "LSCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-02",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "4449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburg, KS

Sources for this page

Verify at the official NPI Registry.