Provider Demographics
NPI:1245659572
Name:VILLEGAS, SUSETTE MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:SUSETTE
Middle Name:MARIE
Last Name:VILLEGAS
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 1:13219 CLOVER CREEK POINT LN
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-3842
Mailing Address - Country:US
Mailing Address - Phone:832-802-9667
Mailing Address - Fax:888-468-6184
Practice Address - Street 1:3411 CEDAR KNOLLS DR
Practice Address - Street 2:SUITE K
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2482
Practice Address - Country:US
Practice Address - Phone:832-802-9667
Practice Address - Fax:888-468-6184
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-15
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX529721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical