Provider Demographics
NPI:1376957290
Name:MCKENZIE, VICTORIA DENISE (MHC-LP)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:DENISE
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-5335
Mailing Address - Country:US
Mailing Address - Phone:212-677-7999
Mailing Address - Fax:
Practice Address - Street 1:743 E 9TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-5335
Practice Address - Country:US
Practice Address - Phone:212-677-7999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-18
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP87649101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health