Provider Demographics
NPI:1417597337
Name:VILANOVA, JOSE (MS, MA, MFT)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:VILANOVA
Suffix:
Gender:M
Credentials:MS, MA, MFT
Other - Prefix:
Other - First Name:TONY
Other - Middle Name:
Other - Last Name:VILANOVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, MA, MFT
Mailing Address - Street 1:333 SCHERMERHORN ST APT 17B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-3492
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:280 MADISON AVE RM 308
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0816
Practice Address - Country:US
Practice Address - Phone:914-557-9113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-08
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP08533106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist