Provider Demographics
NPI:1871698290
Name:VILLENEUVE, WAYNE (EDD)
Entity type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:
Last Name:VILLENEUVE
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20905 PROFESSIONAL PLZ
Mailing Address - Street 2:SUITE 220
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-7783
Mailing Address - Country:US
Mailing Address - Phone:703-858-9841
Mailing Address - Fax:703-858-9446
Practice Address - Street 1:2312 CHESTNUT HILL AVE
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-2923
Practice Address - Country:US
Practice Address - Phone:703-855-1966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional