Doctor Name: | TINA VILLIS |
NPI Number: | 1114150554 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, LCPC |
License Number: | 180.007247 |
Business Practice Address: | 825 W State St 103d Geneva, IL - 601342080 |
Business Phone Number: | 7736271681 |
Business Fax Number: | |
Mailing Address: | 825 W State St, 103d GENEVA |
State: | IL |
Postal Code: | 601342080 |
Phone Number: | 7736271681 |
Fax Number: | |
NPI Enumeration Date: | 09/02/2009 |
NPI Last Update Date: | 04/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 180.007247 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |