Provider Demographics
NPI:1942605118
Name:INTEGRATED BILINGUAL COUNSELING
Entity Type:Organization
Organization Name:INTEGRATED BILINGUAL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:F
Authorized Official - Last Name:VILLAFUERTE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LMSW
Authorized Official - Phone:203-767-3607
Mailing Address - Street 1:259 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-5404
Mailing Address - Country:US
Mailing Address - Phone:203-767-3607
Mailing Address - Fax:
Practice Address - Street 1:628 GEORGE ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5362
Practice Address - Country:US
Practice Address - Phone:203-767-3607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-29
Last Update Date:2015-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT87771041C0700X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty