Provider Demographics
NPI:1326719451
Name:VILI, ROCKY MANUEL (LMSW)
Entity Type:Individual
Prefix:MR
First Name:ROCKY
Middle Name:MANUEL
Last Name:VILI
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 CLEVELAND HEIGHTS RD NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-1607
Mailing Address - Country:US
Mailing Address - Phone:505-938-0683
Mailing Address - Fax:
Practice Address - Street 1:4800 CLEVELAND HEIGHTS RD NE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87144-1607
Practice Address - Country:US
Practice Address - Phone:505-938-0683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-28
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCSA0219821101YA0400X
NMSWB202208201041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty