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General NPI Number Information
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NPI Number | 1003613936
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Entity Type | Individual
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Provider Name | BELEN DE LEON VILLAGRACIA LPC (PA) LMHC (NM)
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Gender | Female
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 1040 CRANBERRY LN W
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City | YORK
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State | PA
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Zip | 17402-7941
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Country | US
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Telephone | 909-465-3018
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Fax |
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Provider Business Mailing Address
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Address Line | 1419 S SANTA BARBARA ST
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City | DEMING
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State | NM
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Zip | 88030-5361
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Country | US
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Telephone | 575-936-4227
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CTB-2025-0063
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC018391
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License Number State | PA
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