Provider Demographics
NPI:1952756835
Name:SCOZZARELLA, VICTOR ANTONIO (MSC, NCC, LPC)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:ANTONIO
Last Name:SCOZZARELLA
Suffix:
Gender:M
Credentials:MSC, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1661 N SWAN RD STE 250
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712
Mailing Address - Country:US
Mailing Address - Phone:520-398-4265
Mailing Address - Fax:
Practice Address - Street 1:1661 N SWAN RD STE 250
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-4053
Practice Address - Country:US
Practice Address - Phone:520-398-4265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-15697101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health