Provider Demographics
NPI:1417743683
Name:VILLAMAR, LUISA (PSYCH)
Entity type:Individual
Prefix:
First Name:LUISA
Middle Name:
Last Name:VILLAMAR
Suffix:
Gender:
Credentials:PSYCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1372 SUMMER ST STE 2
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5366
Mailing Address - Country:US
Mailing Address - Phone:347-514-9594
Mailing Address - Fax:
Practice Address - Street 1:1372 SUMMER ST STE 2
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5366
Practice Address - Country:US
Practice Address - Phone:959-210-6658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No103T00000XBehavioral Health & Social Service ProvidersPsychologist