Provider Demographics
NPI:1063163277
Name:VILLARREAL, CAROLINA (LPC, ATR)
Entity type:Individual
Prefix:MRS
First Name:CAROLINA
Middle Name:
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:LPC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 RIDGEWOOD ST STE 4
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-8466
Mailing Address - Country:US
Mailing Address - Phone:210-675-0066
Mailing Address - Fax:210-618-0324
Practice Address - Street 1:880 RIDGEWOOD ST STE 4
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-8466
Practice Address - Country:US
Practice Address - Phone:210-675-0066
Practice Address - Fax:210-618-0324
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-10
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17-298221700000X
TX81607101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist