Provider Demographics
NPI:1255602447
Name:VILLALOBOS, JOYCE MILDRED (MA, LPC, LISAC, NCC)
Entity type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:MILDRED
Last Name:VILLALOBOS
Suffix:
Gender:F
Credentials:MA, LPC, LISAC, NCC
Other - Prefix:MS
Other - First Name:MICKEY
Other - Middle Name:
Other - Last Name:AMBROSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC, LISAC, NCC
Mailing Address - Street 1:483 W SEED FARM RD
Mailing Address - Street 2:
Mailing Address - City:SACATON
Mailing Address - State:AZ
Mailing Address - Zip Code:85147-5000
Mailing Address - Country:US
Mailing Address - Phone:480-438-9456
Mailing Address - Fax:
Practice Address - Street 1:GILA RIVER HEALTH CARE CORP
Practice Address - Street 2:483 W SEED FARM RD
Practice Address - City:SACATON
Practice Address - State:AZ
Practice Address - Zip Code:85147
Practice Address - Country:US
Practice Address - Phone:520-528-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-19
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-10618101YA0400X
AZLPC-11785101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)