Provider Demographics
NPI:1386007904
Name:MILLIGAN, VICTORIA LYNN (LICSW)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LYNN
Last Name:MILLIGAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SPRINGER ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02127-4130
Mailing Address - Country:US
Mailing Address - Phone:718-650-9880
Mailing Address - Fax:
Practice Address - Street 1:10 FORBES RD
Practice Address - Street 2:SUITE 190
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-2605
Practice Address - Country:US
Practice Address - Phone:781-884-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-31
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1193491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical