Provider Demographics
NPI:1134334121
Name:BOSSE, VICTORIA ANNE (PSYD, LMFT)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:ANNE
Last Name:BOSSE
Suffix:
Gender:F
Credentials:PSYD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1237 WHITTEMORE RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-2433
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1237 WHITTEMORE RD
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-2433
Practice Address - Country:US
Practice Address - Phone:203-577-4579
Practice Address - Fax:203-758-1097
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001134106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT060669107OtherANTHEM BCBS OF CT- WELLMORE GRP/FACILITY
CT060669107OtherUBH-UNITED HEALTHCARE WELLMORE GRP/FACILITY
CTPENDINGOtherAETNA BEHAVIORAL HEALTH
CT008037421Medicaid
CT4923874OtherCIGNA BEHAVIORAL HEALTH
CT549393OtherMHN -MANAGED HEALTH NETWORK
CT549393OtherMHN TRICARE NORTH
CTD339209-WTBY 141OtherVALUE OPTIONS
CT060669107OtherUBH-OXFORD FREEDOM/OXFORD LIBERTY-WELLMORE GRP/FACILITY
CT12707020OtherCAQH
CT549393OtherMHN TRICARE NORTH
CT060669107OtherHEALTHY CT- WELLMORE FACILITY/GRP
CT12707020OtherCAQH
CT4923874OtherCIGNA BEHAVIORAL HEALTH