Provider Demographics
NPI:1720593783
Name:VILLACIS, JULIO STEVEN (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:STEVEN
Last Name:VILLACIS
Suffix:
Gender:M
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5409 NEUSE WOOD DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-7744
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5809 DEPARTURE DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-1935
Practice Address - Country:US
Practice Address - Phone:919-872-6220
Practice Address - Fax:919-872-6220
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-12
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC757108101YM0800X
NC12656101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health