Provider Demographics
NPI:1447482542
Name:VILLARREAL, RAQUEL IRENE (LPC-S)
Entity type:Individual
Prefix:MRS
First Name:RAQUEL
Middle Name:IRENE
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2117 KINGSBOROUGH AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6259
Mailing Address - Country:US
Mailing Address - Phone:956-393-7741
Mailing Address - Fax:
Practice Address - Street 1:2112 W UNIVERSITY DR # 1056
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-2862
Practice Address - Country:US
Practice Address - Phone:956-393-7741
Practice Address - Fax:956-618-4154
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-22
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18555101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX161525401Medicaid