Provider Demographics
NPI:1376671925
Name:KALDERON, VICTORIA (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:
Last Name:KALDERON
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 1:257 WEST 86TH STREET
Mailing Address - Street 2:SUITE # 4C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024
Mailing Address - Country:US
Mailing Address - Phone:888-594-8316
Mailing Address - Fax:
Practice Address - Street 1:257 W 86TH ST
Practice Address - Street 2:SUITE # 4C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3105
Practice Address - Country:US
Practice Address - Phone:888-594-8316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071627101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health