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General NPI Number Information
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NPI Number | 1659766087
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Entity Type | Individual
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Provider Name | CAROLINA VILLAR-MENDEZ
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Gender | Female
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Dates
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Enumeration Date | 04/02/2015
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Last Update Date | 07/16/2023
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Provider Practice Location Address
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Address Line | 801 S RANCHO DR STE C3
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City | LAS VEGAS
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State | NV
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Zip | 89106-3858
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Country | US
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Telephone | 702-385-2153
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Fax |
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Provider Business Mailing Address
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Address Line | 5050 SPRING VALLEY RD
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City | DALLAS
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State | TX
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Zip | 75244-3995
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Country | US
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Telephone | 972-367-4845
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Fax | 972-367-3451
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CP0074
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License Number State | NV
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