MEDICARE: DR. DEILEN MICHELLE VILLEGAS PHD, DNM, BCNP, CPD

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	171400000X	Health & Wellness Coach
2	202D00000X	Integrative Medicine Physician	11534501	NC
3	175F00000X	Naturopath
4	101Y00000X	Counselor
5	174H00000X	Health Educator
6	133NN1002X	Nutrition Education Nutritionist
7	175M00000X	Lay Midwife
8	374J00000X	Doula
9	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1356179550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEILEN MICHELLE VILLEGAS PHD, DNM, BCNP, CPD

Provider Business Mailing Address
First Line	:	425 AUBREY WOODS DR
Second Line	:
City	:	KINGS MOUNTAIN
State	:	NC
Zip	:	28086-0089
Country	:	US
Telephone Number	:	704-750-5170
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 AUBREY WOODS DR
Second Line	:
City	:	KINGS MOUNTAIN
State	:	NC
Zip	:	28086-0089
Country	:	US
Telephone Number	:	704-750-5170
Fax Number	:

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

Provider Enumeration Date	:	07/22/2024
Last Update Date	:	01/11/2026

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