Provider Demographics
NPI:1639338973
Name:VILLEGAS, MICHELLE SUSAN BOYD (LCSW)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:SUSAN BOYD
Last Name:VILLEGAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 719
Mailing Address - Street 2:
Mailing Address - City:CARPINTERIA
Mailing Address - State:CA
Mailing Address - Zip Code:93014-0719
Mailing Address - Country:US
Mailing Address - Phone:805-570-1217
Mailing Address - Fax:
Practice Address - Street 1:1482 E VALLEY RD STE 11
Practice Address - Street 2:
Practice Address - City:MONTECITO
Practice Address - State:CA
Practice Address - Zip Code:93108-1200
Practice Address - Country:US
Practice Address - Phone:805-570-1217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA206601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical