MEDICARE: VICTORIA MCCOLLUM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	CW025979	PA

General Provider Information

NPI Number	:	1235900671
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA MCCOLLUM

Provider Business Mailing Address
First Line	:	1638 AMOSLAND RD
Second Line	:
City	:	PROSPECT PARK
State	:	PA
Zip	:	19076-1016
Country	:	US
Telephone Number	:	610-945-8471
Fax Number	:

Provider Business Practice Location Address
First Line	:	1638 AMOSLAND RD
Second Line	:
City	:	PROSPECT PARK
State	:	PA
Zip	:	19076-1016
Country	:	US
Telephone Number	:	610-945-8471
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2024
Last Update Date	:	05/21/2025

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Directions to “ VICTORIA MCCOLLUM ” Practice Location

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