Provider Demographics
NPI:1982199451
Name:VILLARREAL, VANESSA BELTRAN (MED, LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:BELTRAN
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:MED, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 E LEVEE ST STE 206
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-5266
Mailing Address - Country:US
Mailing Address - Phone:956-277-4040
Mailing Address - Fax:
Practice Address - Street 1:700 E LEVEE ST STE 206
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-5266
Practice Address - Country:US
Practice Address - Phone:956-277-4040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-27
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73955101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional