Provider Demographics
NPI:1790920585
Name:VILLAGOMEZ, LUISA BELECHE (LCSW,LICSW)
Entity type:Individual
Prefix:MS
First Name:LUISA
Middle Name:BELECHE
Last Name:VILLAGOMEZ
Suffix:
Gender:F
Credentials:LCSW,LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 4TH ST N STE 300
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-4399
Mailing Address - Country:US
Mailing Address - Phone:408-681-9441
Mailing Address - Fax:833-672-3225
Practice Address - Street 1:7901 4TH ST N STE 300
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-4399
Practice Address - Country:US
Practice Address - Phone:408-681-9441
Practice Address - Fax:833-672-3225
Is Sole Proprietor?:No
Enumeration Date:2008-12-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA719061041C0700X
FLSW175411041C0700X
DCLC2000032181041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical