Provider Demographics
NPI:1972950855
Name:BOATENG, VICTORIA (DHA, LCSWR, M-CASAC)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:
Last Name:BOATENG
Suffix:
Gender:F
Credentials:DHA, LCSWR, M-CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:838 PELHAMDALE AVE # Q
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-1032
Mailing Address - Country:US
Mailing Address - Phone:914-316-4684
Mailing Address - Fax:914-933-8860
Practice Address - Street 1:838 PELHAMDALE AVE # Q
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-1032
Practice Address - Country:US
Practice Address - Phone:914-316-4684
Practice Address - Fax:914-933-8860
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-19
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY24814101YA0400X
0879951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)