Provider Demographics
NPI:1093872970
Name:VILLONE, PHILIP (LCSW)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:
Last Name:VILLONE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 THE GLN
Mailing Address - Street 2:34 UNDERHILL DRIVE
Mailing Address - City:TAMIMENT
Mailing Address - State:PA
Mailing Address - Zip Code:18371-9701
Mailing Address - Country:US
Mailing Address - Phone:570-588-2776
Mailing Address - Fax:
Practice Address - Street 1:8 THE GLN
Practice Address - Street 2:34 UNDERHILL DRIVE
Practice Address - City:TAMIMENT
Practice Address - State:PA
Practice Address - Zip Code:18371-9701
Practice Address - Country:US
Practice Address - Phone:570-588-2776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR013111-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical