Provider Demographics
NPI:1841493277
Name:VILLEGAS, YOLANDA (MA LMHC)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:VILLEGAS
Suffix:
Gender:F
Credentials:MA LMHC
Other - Prefix:
Other - First Name:YOLANDA
Other - Middle Name:
Other - Last Name:TROCHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA LMHC
Mailing Address - Street 1:PO BOX 39161
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98496-3161
Mailing Address - Country:US
Mailing Address - Phone:253-327-1669
Mailing Address - Fax:855-210-4465
Practice Address - Street 1:2607 BRIDGEPORT WAY W STE 2D
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4725
Practice Address - Country:US
Practice Address - Phone:253-327-1669
Practice Address - Fax:855-210-4465
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60183269101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1980945Medicaid
19849633OtherAETNA ID
12503071OtherCAQH ID
8954093OtherL&I