Provider Demographics
NPI:1902025216
Name:GOODMAN-STRENSKI, VICTORIA G (MSSW LCSW CSAC)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:G
Last Name:GOODMAN-STRENSKI
Suffix:
Gender:F
Credentials:MSSW LCSW CSAC
Other - Prefix:
Other - First Name:VICKTORIA
Other - Middle Name:G
Other - Last Name:GOODMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:313 PRICE PL
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-3299
Mailing Address - Country:US
Mailing Address - Phone:608-334-5568
Mailing Address - Fax:
Practice Address - Street 1:313 PRICE PL
Practice Address - Street 2:SUITE 10
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-3299
Practice Address - Country:US
Practice Address - Phone:608-334-5568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1925101YA0400X
WI29941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39655000Medicaid
R63753Medicare UPIN
WI39655000Medicaid