Provider Demographics
NPI:1255109120
Name:VILLATORO, DANESSIA (LMSW)
Entity type:Individual
Prefix:
First Name:DANESSIA
Middle Name:
Last Name:VILLATORO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 W 11TH ST
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-4011
Mailing Address - Country:US
Mailing Address - Phone:631-231-4333
Mailing Address - Fax:
Practice Address - Street 1:13 MCWHORTER ST
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-3207
Practice Address - Country:US
Practice Address - Phone:631-231-4333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1224171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical