Provider Demographics
NPI:1558150151
Name:TESKA, VICTORIA ANNE (CADC2)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:ANNE
Last Name:TESKA
Suffix:
Gender:
Credentials:CADC2
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5555 VAUGHN RD
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-2007
Mailing Address - Country:US
Mailing Address - Phone:678-372-3099
Mailing Address - Fax:
Practice Address - Street 1:4390 EARNEY RD STE 110
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-5687
Practice Address - Country:US
Practice Address - Phone:678-568-2285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA01847101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)