Provider Demographics
NPI:1093298275
Name:NAGEL, VICTORIA ASHLEY (LPC,LCADC)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:ASHLEY
Last Name:NAGEL
Suffix:
Gender:F
Credentials:LPC,LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 US HIGHWAY 206 STE 202
Mailing Address - Street 2:
Mailing Address - City:FLANDERS
Mailing Address - State:NJ
Mailing Address - Zip Code:07836-9190
Mailing Address - Country:US
Mailing Address - Phone:908-285-5968
Mailing Address - Fax:
Practice Address - Street 1:230 ROUTE 206 BLDG 3
Practice Address - Street 2:
Practice Address - City:FLANDERS
Practice Address - State:NJ
Practice Address - Zip Code:07836-9189
Practice Address - Country:US
Practice Address - Phone:908-285-5968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00246100101YA0400X
NJ37PC00627200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)