MEDICARE: ERICA GAIL VILLEGAS LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	56272	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	56272	OTHER	TX	TX STATE BOARD OF SOCIAL WORKER EXAMINERS

General Provider Information

NPI Number	:	1164865812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA GAIL VILLEGAS LCSW

Provider Business Mailing Address
First Line	:	PO BOX 66308
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77266-6308
Country	:	US
Telephone Number	:	832-548-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	5616 LAWNDALE ST.
Second Line	:	STE A108 AND A110
City	:	HOUSTON
State	:	TX
Zip	:	77023-3821
Country	:	US
Telephone Number	:	832-548-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2013
Last Update Date	:	07/21/2022

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