Provider Demographics
NPI:1639236235
Name:CRAIG, VICTORIA JOHANNA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:JOHANNA
Last Name:CRAIG
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 1:23 LAPIN LANE
Mailing Address - Street 2:
Mailing Address - City:BLAUVELT
Mailing Address - State:NY
Mailing Address - Zip Code:10913-1619
Mailing Address - Country:US
Mailing Address - Phone:845-680-0836
Mailing Address - Fax:914-631-2462
Practice Address - Street 1:303 SOUTH BROADWAY SUITE 321
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591
Practice Address - Country:US
Practice Address - Phone:914-372-2089
Practice Address - Fax:914-631-2462
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR04927011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical