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Individual

JOSE VILLAFUERTE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW, LMSW

Contact information

Practice address
628 GEORGE ST, NEW HAVEN, CT 06511-5362
(475) 422-1819
Mailing address
628 GEORGE ST, NEW HAVEN, CT 06511-5362
(475) 422-1819

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
1041C0700X
Clinical Social Worker
Primary
8777
CT

Other

Enumeration date
06/11/2013
Last updated
11/05/2014
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