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NPI Code Detail

MEDICARE: KELSIE VILLA

MEDICARE: KELSIE VILLA
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
11041C0700XClinical Social Worker111917TX

General Provider Information

NPI Number : 1942165154
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSIE VILLA
Provider Business Mailing Address
First Line : PO BOX 890
Second Line :
City : WACO
State : TX
Zip : 76703-0890
Country : US
Telephone Number : 254-652-6922
Fax Number :
Provider Business Practice Location Address
First Line : 110 S 12TH ST
Second Line :
City : WACO
State : TX
Zip : 76701-1810
Country : US
Telephone Number : 254-652-6922
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2025
Last Update Date : 12/19/2025

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Directions to “ KELSIE VILLA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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