Provider Demographics
NPI:1285863241
Name:TILBE, VICTORIA FERN (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:FERN
Last Name:TILBE
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 THORN APPLE LN
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4445
Mailing Address - Country:US
Mailing Address - Phone:585-478-5732
Mailing Address - Fax:
Practice Address - Street 1:87 THORN APPLE LN
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4445
Practice Address - Country:US
Practice Address - Phone:585-478-5732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR058606-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY11448121OtherBLUE CROSS BLUE SHIELD
NY11448121OtherMVP