Provider Demographics
NPI:1578285979
Name:OSHEA, VICTORIA MARIE (LMHC, CASAC)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:MARIE
Last Name:OSHEA
Suffix:
Gender:F
Credentials:LMHC, CASAC
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:MARIE
Other - Last Name:WALLACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CASAC
Mailing Address - Street 1:12 WILLIAM ST APT W
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-4250
Mailing Address - Country:US
Mailing Address - Phone:347-675-2760
Mailing Address - Fax:
Practice Address - Street 1:12 WILLIAM ST APT W
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-4250
Practice Address - Country:US
Practice Address - Phone:347-675-2760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY16990101YA0400X
NY012809101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)