Individual
JOSE VILLANUEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ADVANCED CASAC
Contact information
Practice address
43 SUMMIT AVE FL 1, ALBANY, NY 12209-1613
(518) 535-9030
Mailing address
43 SUMMIT AVE FL 1, ALBANY, NY 12209-1613
(518) 535-9030
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
27230
NY
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251B00000X
Case Management Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27230
NYS DEPARTMENT OF OASAS
NY
Enumeration date
06/23/2021
Last updated
06/23/2021
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