Provider Demographics
NPI:1144046657
Name:VILLEGAS PERKINS, KAYLEE ALYSSA (LCSW)
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:ALYSSA
Last Name:VILLEGAS PERKINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9071
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78766-9071
Mailing Address - Country:US
Mailing Address - Phone:512-993-5650
Mailing Address - Fax:
Practice Address - Street 1:8510 NEW HAMPSHIRE DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-7434
Practice Address - Country:US
Practice Address - Phone:512-993-5650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-29
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1058731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty