| Doctor Name: | SELENE CASTRO |
| NPI Number: | 1275905655 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 29634 |
| Business Practice Address: | 31979 N Fish Lake Rd Round Lake, IL - 600739517 |
| Business Phone Number: | 8475466450 |
| Business Fax Number: | 8475466760 |
| Mailing Address: | 1029 Jackson St, NORTH CHICAGO |
| State: | IL |
| Postal Code: | 600641237 |
| Phone Number: | 8472088191 |
| Fax Number: | |
| NPI Enumeration Date: | 10/26/2015 |
| NPI Last Update Date: | 10/26/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 29634 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |