Provider Demographics
NPI:1801869102
Name:MASIH, VICTORIA S (LCSW)
Entity type:Individual
Prefix:MISS
First Name:VICTORIA
Middle Name:S
Last Name:MASIH
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 1:4420 LAREDO MEADOW PT
Mailing Address - Street 2:APARTMENT 208
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80922-4002
Mailing Address - Country:US
Mailing Address - Phone:719-380-0813
Mailing Address - Fax:
Practice Address - Street 1:1650 COCHRANE CIRCLE, BUILDING 7500
Practice Address - Street 2:EVANS ARMY COMMUNITY HOPSITAL
Practice Address - City:FORT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913
Practice Address - Country:US
Practice Address - Phone:719-526-7399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX377511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical