Provider Demographics
NPI:1427606086
Name:WILLEFORD, DENA LYNNETTE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:DENA
Middle Name:LYNNETTE
Last Name:WILLEFORD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1162 E SONTERRA BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4048
Mailing Address - Country:US
Mailing Address - Phone:210-816-3132
Mailing Address - Fax:
Practice Address - Street 1:1162 E SONTERRA BLVD STE 130
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4048
Practice Address - Country:US
Practice Address - Phone:210-490-9062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-27
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74799101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional