Kim Marie Villarreal, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

53764 Issued in TX

Practice address

4418 Revetment Way
San Antonio, TX 78223-2489

Phone

(832) 596-1019

NPI assigned

Jan 9, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1641686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1932860194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4418 REVETMENT WAY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782232489",
            "telephone_number": "832-596-1019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4418 REVETMENT WAY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782232489",
            "telephone_number": "832-596-1019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLARREAL",
        "first_name": "KIM",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-09",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "53764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Arlington",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "708 N. Edison St.",
            "city": "Arlington",
            "state": "VA",
            "country_code": "US",
            "postal_code": "22203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Roberts Villarreal
• Jodi-Anne Kimone Villarreal
• Judy Angela Villarreal
• Karina Villarreal, APRN
• Katherine Leang Villarreal, CPNP
• Kimberly Villarreal
• Kimberly M Villarreal, LMT
• Kristen Nikole Villarreal
• Laura A Villarreal, M.D.
• Laura Cristina Villarreal, PHARMD

• Mental Health Counselor in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; 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.