MEDICARE: RAFAEL VILLAFANE-GONZALEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1811455884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAFAEL VILLAFANE-GONZALEZ

Provider Business Mailing Address
First Line	:	77 MILL ST
Second Line	:
City	:	WESTFIELD
State	:	MA
Zip	:	01085-4598
Country	:	US
Telephone Number	:	413-266-9639
Fax Number	:	413-534-3238

Provider Business Practice Location Address
First Line	:	77 MILL ST
Second Line	:
City	:	WESTFIELD
State	:	MA
Zip	:	01085-4598
Country	:	US
Telephone Number	:	413-266-9639
Fax Number	:	413-534-3238

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2019
Last Update Date	:	04/06/2026

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