Provider Demographics
NPI:1447588082
Name:MARCHESE, VICTOR (LCSW)
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:
Last Name:MARCHESE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 GLEN HEAD RD
Mailing Address - Street 2:STE 212
Mailing Address - City:GLEN HEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11545-1962
Mailing Address - Country:US
Mailing Address - Phone:516-869-1832
Mailing Address - Fax:516-656-3399
Practice Address - Street 1:333 GLEN HEAD RD
Practice Address - Street 2:STE 212
Practice Address - City:GLEN HEAD
Practice Address - State:NY
Practice Address - Zip Code:11545-1962
Practice Address - Country:US
Practice Address - Phone:516-869-1832
Practice Address - Fax:516-656-3399
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-19
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0540821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical