Provider Demographics
NPI:1003958596
Name:VILARDO, JANICE I (LCSWR)
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:I
Last Name:VILARDO
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 PEDDLER HILL ROAD
Mailing Address - Street 2:APT #3
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950
Mailing Address - Country:US
Mailing Address - Phone:845-783-5119
Mailing Address - Fax:
Practice Address - Street 1:375 RTE 32
Practice Address - Street 2:
Practice Address - City:CENTRAL VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10917
Practice Address - Country:US
Practice Address - Phone:845-928-5363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0440291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
745027OtherAETNA
NY02044071Medicaid
617293OtherMVP
121420OtherVALUE OPTIONS
6884499OtherGHI BMP
P2457714OtherOXFORD
218798OtherMANGED HEALTH NETWORK MHN
NF4841OtherBLUE CROSS BLUE SHIELD
617293OtherMVP
218798OtherMANGED HEALTH NETWORK MHN