Provider Demographics
NPI:1780202689
Name:VILLESCAS, ALICIA MAE (PLMHP)
Entity Type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:MAE
Last Name:VILLESCAS
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3610 N 49TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-3650
Mailing Address - Country:US
Mailing Address - Phone:402-973-0845
Mailing Address - Fax:402-590-2030
Practice Address - Street 1:4565 S 133RD ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-1142
Practice Address - Country:US
Practice Address - Phone:402-590-2947
Practice Address - Fax:402-590-2030
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-08
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12265101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor