Provider Demographics
NPI:1619044872
Name:DELLAPORTE, VICTORIA R (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:R
Last Name:DELLAPORTE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:R
Other - Last Name:LEBEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:LENAPE VALLEY FOUNDATION
Mailing Address - Street 2:500 N. WEST ST
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901
Mailing Address - Country:US
Mailing Address - Phone:267-893-5476
Mailing Address - Fax:215-885-3090
Practice Address - Street 1:LENAPE VALLEY FOUNDATION
Practice Address - Street 2:500 N. WEST ST
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901
Practice Address - Country:US
Practice Address - Phone:267-893-5476
Practice Address - Fax:215-885-3090
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0133761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA007024828-0002Medicaid
PA056232E91Medicaid