Provider Demographics
NPI:1598658957
Name:SMOCK, VICTORIA NOEL (MED, BCBA, LBS)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:NOEL
Last Name:SMOCK
Suffix:
Gender:F
Credentials:MED, BCBA, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 MOUNT VERNON DR APT A
Mailing Address - Street 2:
Mailing Address - City:ELLWOOD CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16117-1408
Mailing Address - Country:US
Mailing Address - Phone:724-674-6181
Mailing Address - Fax:
Practice Address - Street 1:346 MOUNT VERNON DR APT A
Practice Address - Street 2:
Practice Address - City:ELLWOOD CITY
Practice Address - State:PA
Practice Address - Zip Code:16117-1408
Practice Address - Country:US
Practice Address - Phone:724-674-6181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH005256103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst