Provider Demographics
NPI:1255937744
Name:VILLANUEVA, LENICE MARCELINA (LPC)
Entity type:Individual
Prefix:
First Name:LENICE
Middle Name:MARCELINA
Last Name:VILLANUEVA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7458 E CURRY RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78542-7392
Mailing Address - Country:US
Mailing Address - Phone:956-292-3089
Mailing Address - Fax:
Practice Address - Street 1:415 E 14TH ST
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-4075
Practice Address - Country:US
Practice Address - Phone:956-323-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79424101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional