Healthcare Provider Details

I. General information

NPI: 1720529670
Provider Name (Legal Business Name): VICTORIA SCHUCH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2017
Last Update Date: 01/19/2023
Certification Date: 01/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 ALBANY TPKE STE 3
CANTON CT
06019-2554
US

IV. Provider business mailing address

49 LEXINGTON RD
WEST HARTFORD CT
06119-1748
US

V. Phone/Fax

Practice location:
  • Phone: 203-819-0789
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10547
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: