Provider Demographics
NPI:1154776417
Name:VILLEGAS, JOSIE (LMSW)
Entity type:Individual
Prefix:
First Name:JOSIE
Middle Name:
Last Name:VILLEGAS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 W ROBERT AVE
Mailing Address - Street 2:
Mailing Address - City:HAZEL PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48030-3222
Mailing Address - Country:US
Mailing Address - Phone:517-918-0233
Mailing Address - Fax:
Practice Address - Street 1:33875 KIELY DR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-3604
Practice Address - Country:US
Practice Address - Phone:586-716-7092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010918801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical