Provider Demographics
NPI:1518914878
Name:CAREY, VICTORIA (MSW, LISW-CP)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:CAREY
Suffix:
Gender:F
Credentials:MSW, LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 PEPPERBUSH DR
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-4163
Mailing Address - Country:US
Mailing Address - Phone:843-333-1363
Mailing Address - Fax:
Practice Address - Street 1:727 PEPPERBUSH DR
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29579-4163
Practice Address - Country:US
Practice Address - Phone:843-333-1363
Practice Address - Fax:864-448-1448
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-30
Last Update Date:2020-11-20
Deactivation Date:2010-06-18
Deactivation Code:
Reactivation Date:2020-04-16
Provider Licenses
StateLicense IDTaxonomies
SC0073041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical