Individual provider Active NPI

Vanessa Veronica Villavicencio, MA, LMHC

  • Mental Health Counselor
  • Lynnwood, WA
National Provider Identifier
1184813354
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH00007024 Issued in WA
Practice address
20102 Cedar Valley Rd
Suite 107
Lynnwood, WA 98036-6333
Phone
(206) 579-0585
NPI assigned
Oct 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH00007024 WA Primary

Addresses

Primary practice location

20102 Cedar Valley Rd
Suite 107
Lynnwood, WA 98036-6333

Mailing address

20301 19TH Ave NE
Suite 421
Shoreline, WA 98155-1285
Phone (206) 579-0585

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LH00007024WAMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194307200000",
    "number": "1184813354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20301 19TH AVE NE",
            "address_2": "SUITE 421",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981551285",
            "telephone_number": "206-579-0585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20102 CEDAR VALLEY RD",
            "address_2": "SUITE 107",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366333",
            "telephone_number": "206-579-0585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAVICENCIO",
        "first_name": "VANESSA",
        "middle_name": "VERONICA",
        "name_prefix": "Mrs.",
        "credential": "MA, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-23",
        "last_updated": "2007-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00007024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.