MEDICARE: KAREN S VILLARREAL LMSW, LCDC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	7802	TX
2	104100000X	Social Worker	37121	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801930953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN S VILLARREAL LMSW, LCDC

Provider Business Mailing Address
First Line	:	PO BOX 748465
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-8465
Country	:	US
Telephone Number	:	855-284-7748
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 LAKE WOODLANDS DR STE 4009
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77380-5000
Country	:	US
Telephone Number	:	855-284-7748
Fax Number	:

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

Provider Enumeration Date	:	02/19/2007
Last Update Date	:	08/30/2023

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