Provider Demographics
NPI:1114643269
Name:VILLARREAL, FELINA NICHOLETTE (MS ED)
Entity type:Individual
Prefix:MRS
First Name:FELINA
Middle Name:NICHOLETTE
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5597 AISEK ST
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-9522
Mailing Address - Country:US
Mailing Address - Phone:907-780-4338
Mailing Address - Fax:
Practice Address - Street 1:5590 AISEK ST
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-9522
Practice Address - Country:US
Practice Address - Phone:907-780-4338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-19
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
AK232057101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1737287Medicaid