MEDICARE: VICTORIA MACKNIGHT LCSW

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	LC23565	ME

General Provider Information

NPI Number	:	1447096219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA MACKNIGHT LCSW

Provider Business Mailing Address
First Line	:	2509 WHEELER AVE APT A
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-4186
Country	:	US
Telephone Number	:	585-355-6897
Fax Number	:

Provider Business Practice Location Address
First Line	:	6909 TITUS BLVD BLDG 2361
Second Line	:
City	:	FORT CARSON
State	:	CO
Zip	:	80913-4429
Country	:	US
Telephone Number	:	719-526-3734
Fax Number	:

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

Provider Enumeration Date	:	07/02/2024
Last Update Date	:	03/02/2026

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