Provider Demographics
NPI:1023368917
Name:HUMMER, VICTORIA LATHAM (LCSW)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LATHAM
Last Name:HUMMER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE CRISIS CENTER PLAZA
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-1238
Mailing Address - Country:US
Mailing Address - Phone:813-969-4922
Mailing Address - Fax:813-969-4950
Practice Address - Street 1:ONE CRISIS CENTER PLAZA
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-1238
Practice Address - Country:US
Practice Address - Phone:813-264-9955
Practice Address - Fax:813-969-4950
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW40221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1013902956OtherGROUP NPI
FL088345003Medicaid