Provider Demographics
NPI:1457183741
Name:VILLEGAS-PORRAS, JESSICA (LPC-A)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:VILLEGAS-PORRAS
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6040 SURETY DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2043
Mailing Address - Country:US
Mailing Address - Phone:915-781-9900
Mailing Address - Fax:
Practice Address - Street 1:6040 SURETY DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2043
Practice Address - Country:US
Practice Address - Phone:915-781-9900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional