Provider Demographics
NPI:1336318112
Name:VILLALOBOS, RICARDO (MA, NCC)
Entity Type:Individual
Prefix:MR
First Name:RICARDO
Middle Name:
Last Name:VILLALOBOS
Suffix:
Gender:M
Credentials:MA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5232 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-1621
Mailing Address - Country:US
Mailing Address - Phone:703-351-4933
Mailing Address - Fax:
Practice Address - Street 1:5232 LEE HWY
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22207-1621
Practice Address - Country:US
Practice Address - Phone:703-351-4933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0701004046101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional