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NPI Code Detail

MEDICARE: VICTORIA ELIZABETH DEVINE LICSW

MEDICARE: VICTORIA ELIZABETH DEVINE LICSW
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
1104100000XSocial Worker
21041C0700XClinical Social Worker124271MA

General Provider Information

NPI Number : 1922597509
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA ELIZABETH DEVINE LICSW
Provider Business Mailing Address
First Line : 9 DAMON ST
Second Line :
City : DANVERS
State : MA
Zip : 01923-3205
Country : US
Telephone Number : 978-849-4222
Fax Number :
Provider Business Practice Location Address
First Line : 10 TOWER OFFICE PARK STE 413
Second Line :
City : WOBURN
State : MA
Zip : 01801-2120
Country : US
Telephone Number : 978-338-4494
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2018
Last Update Date : 03/29/2026

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Directions to “ VICTORIA ELIZABETH DEVINE LICSW” Practice Location

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