Provider Demographics
NPI:1033859269
Name:SIMONELLI, VICTORIA KATE (BA)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:KATE
Last Name:SIMONELLI
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 NEWBURY ST APT 6101
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-5226
Mailing Address - Country:US
Mailing Address - Phone:781-572-5697
Mailing Address - Fax:
Practice Address - Street 1:180 NEWBURY ST APT 6101
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-5226
Practice Address - Country:US
Practice Address - Phone:781-572-5697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty