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General NPI Number Information
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NPI Number | 1790593465
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Entity Type | Individual
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Provider Name | ANNE JENSEN VILLANO LSW
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Gender | Female
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Dates
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Enumeration Date | 12/26/2024
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Last Update Date | 12/26/2024
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Provider Practice Location Address
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Address Line | 6430 BROOK PARK DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-1432
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Country | US
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Telephone | 855-222-1610
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Fax |
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Provider Business Mailing Address
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Address Line | 16408 BLUE YONDER VW
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City | MONUMENT
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State | CO
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Zip | 80132-7806
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Country | US
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Telephone | 518-353-3822
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW229304
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LSW.0009925783
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License Number State | CO
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