Provider Demographics
NPI:1225361108
Name:VICTORIA L. WOODS, LCSW, LLC
Entity Type:Organization
Organization Name:VICTORIA L. WOODS, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:602-679-5273
Mailing Address - Street 1:727 E BETHANY HOME RD
Mailing Address - Street 2:SUITE C-102
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-2198
Mailing Address - Country:US
Mailing Address - Phone:602-679-5273
Mailing Address - Fax:602-216-9590
Practice Address - Street 1:727 E BETHANY HOME RD
Practice Address - Street 2:SUITE C-102
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2198
Practice Address - Country:US
Practice Address - Phone:602-679-5273
Practice Address - Fax:602-216-9590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-10
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-11749251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health