Healthcare Provider Details

I. General information

NPI: 1033052642
Provider Name (Legal Business Name): WORTHY OF WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2026
Last Update Date: 04/10/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12518 QUEENS BLVD
KEW GARDENS NY
11415-1503
US

IV. Provider business mailing address

12518 QUEENS BLVD
KEW GARDENS NY
11415-1503
US

V. Phone/Fax

Practice location:
  • Phone: 347-885-7102
  • Fax:
Mailing address:
  • Phone: 347-885-7102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: JESSICA VILLALVIR
Title or Position: CEO
Credential: MS RDN CDN LDN
Phone: 347-885-7102