Provider Demographics
NPI:1508561440
Name:LORICK, VICTORIA (LCSW)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:LORICK
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 1:9325 TARVER DR STE A-102
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-6162
Mailing Address - Country:US
Mailing Address - Phone:254-218-3295
Mailing Address - Fax:
Practice Address - Street 1:9325 TARVER DR STE A-102
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-6162
Practice Address - Country:US
Practice Address - Phone:254-218-3295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX653191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical