Provider Demographics
NPI:1023445731
Name:VILLARREAL, MACEY LYNN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MACEY
Middle Name:LYNN
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MACEY
Other - Middle Name:LYNN
Other - Last Name:LOIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1517 KREMER AVE
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53402-2723
Mailing Address - Country:US
Mailing Address - Phone:321-505-6327
Mailing Address - Fax:
Practice Address - Street 1:8800 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53406-3701
Practice Address - Country:US
Practice Address - Phone:262-633-3591
Practice Address - Fax:262-633-2619
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-27
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker