=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194632869
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ISABEL VILLANUEVA LADAC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/26/2026
-----------------------------------------------------
Last Update Date | 08/26/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 215 W BROADWAY ST STE 1
-----------------------------------------------------
City | HOBBS
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 88240-6075
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 575-433-2211
-----------------------------------------------------
Fax | 575-433-4211
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1327 N SAN ANDRES DR
-----------------------------------------------------
City | HOBBS
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 88240-4857
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 575-433-2211
-----------------------------------------------------
Fax | 575-433-4211
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | CTB-2026-0190
-----------------------------------------------------
License Number State | NM
-----------------------------------------------------