Provider Demographics
NPI:1629322011
Name:POWERS, VICTORIA ANN (MSW, LSW)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:ANN
Last Name:POWERS
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:MS
Other - First Name:VICTORIA
Other - Middle Name:ANN
Other - Last Name:FRAGASSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LSW
Mailing Address - Street 1:383 RITTENHOUSE CT
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-3536
Mailing Address - Country:US
Mailing Address - Phone:732-406-8285
Mailing Address - Fax:
Practice Address - Street 1:2035 LINCOLN HWY STE 1150
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-3351
Practice Address - Country:US
Practice Address - Phone:866-557-8669
Practice Address - Fax:732-761-0305
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-06
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05644700104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker