Provider Demographics
NPI:1013452762
Name:VILLARREAL, RUTH (MED, LPC)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8400 JAMESTOWN DR APT 206
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-7938
Mailing Address - Country:US
Mailing Address - Phone:512-730-0649
Mailing Address - Fax:
Practice Address - Street 1:8400 JAMESTOWN DR APT 206
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-7938
Practice Address - Country:US
Practice Address - Phone:512-730-0649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-04
Last Update Date:2020-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68648101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional