Provider Demographics
NPI:1255967659
Name:VILLARREAL, JESSICA (PHD, LPC-S, LMFT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:PHD, LPC-S, LMFT
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:BORDLEMAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, LPC-S, LMFT
Mailing Address - Street 1:1735 KELLER SPRINGS RD STE 202
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-3006
Mailing Address - Country:US
Mailing Address - Phone:844-824-8775
Mailing Address - Fax:
Practice Address - Street 1:1735 KELLER SPRINGS RD STE 202
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-3006
Practice Address - Country:US
Practice Address - Phone:214-618-8402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-17
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68336101YM0800X, 101YP2500X
TX203094106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional