Provider Demographics
NPI:1265582167
Name:WEBER, VICTORIA ANN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:ANN
Last Name:WEBER
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 1:8147 DELMAR BLVD
Mailing Address - Street 2:SUITE #2
Mailing Address - City:UNIVERSITY CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63130-3735
Mailing Address - Country:US
Mailing Address - Phone:314-725-0551
Mailing Address - Fax:
Practice Address - Street 1:8147 DELMAR BLVD
Practice Address - Street 2:SUITE #2
Practice Address - City:UNIVERSITY CITY
Practice Address - State:MO
Practice Address - Zip Code:63130-3735
Practice Address - Country:US
Practice Address - Phone:314-725-0551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0003251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO061646OtherVALUEOPTIONS