Provider Demographics
NPI:1497813075
Name:VANDERSLICE, VICTORIA JEAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:JEAN
Last Name:VANDERSLICE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7709 S MONACO CIR E
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-2581
Mailing Address - Country:US
Mailing Address - Phone:303-771-5515
Mailing Address - Fax:
Practice Address - Street 1:5500 S SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-8201
Practice Address - Country:US
Practice Address - Phone:303-347-6438
Practice Address - Fax:303-797-9354
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9921891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC423128Medicare PIN