Provider Demographics
NPI:1659902989
Name:GLOVER, VICTORIA ROSA (LPC)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ROSA
Last Name:GLOVER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 BROOK RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30340-3841
Mailing Address - Country:US
Mailing Address - Phone:229-322-1990
Mailing Address - Fax:
Practice Address - Street 1:834 BROOK RIDGE AVE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30340-3841
Practice Address - Country:US
Practice Address - Phone:229-322-1990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-27
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006938101YM0800X
GA013112101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health