Healthcare Provider Details

I. General information

NPI: 1154132645
Provider Name (Legal Business Name): WESLEY VILLANO LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2025
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2439 MANHATTAN BLVD
HARVEY LA
70058-5328
US

IV. Provider business mailing address

2439 MANHATTAN BLVD
HARVEY LA
70058-5328
US

V. Phone/Fax

Practice location:
  • Phone: 504-333-6657
  • Fax:
Mailing address:
  • Phone: 504-333-6657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number130473
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: