Provider Demographics
NPI:1093022170
Name:PRISCO, VICTORIA JEAN (ATR, LCAT, LPC)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:JEAN
Last Name:PRISCO
Suffix:
Gender:F
Credentials:ATR, LCAT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 LOMBARD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-1260
Mailing Address - Country:US
Mailing Address - Phone:215-280-4090
Mailing Address - Fax:
Practice Address - Street 1:929 LOMBARD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-1260
Practice Address - Country:US
Practice Address - Phone:215-280-4090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-09
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010104101Y00000X, 101YP2500X
NY001276221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist