Jorge Luis Villafuerte, LMHC

Individual provider Active NPI Mental Health Counselor · Canutillo, TX

NPI 1063663482 · NPPES record last updated Oct 3, 2008

Key facts

NPI
1063663482
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
0116781 (NM)
Practice address
6621 Doniphan Dr Ste G
Canutillo, TX 79835-5005
Phone
(915) 877-5100
Fax
(915) 877-5107
NPI assigned
Oct 3, 2008
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0116781NMMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sunwest Behavioral Associates PA Mental Health Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0116781 NM Yes

Addresses

Primary practice location

6621 Doniphan Dr Ste G
Canutillo, TX 79835-5005

Mailing address

6621 Doniphan Dr Ste G
Canutillo, TX 79835-5005
Phone (915) 877-5100

Other identifiers

IdentifierTypeStateIssuer
VNM30451NIMedicaidNM

Other providers in Canutillo, TX

All providers in Canutillo, TX · Mental Health Counselor in Texas

Sources for this page

Verify at the official NPI Registry.