Healthcare Provider Details

I. General information

NPI: 1386371714
Provider Name (Legal Business Name): VICTORIA GEORGE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2022
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

883 PADDOCK AVE
MERIDEN CT
06450-7044
US

IV. Provider business mailing address

883 PADDOCK AVE
MERIDEN CT
06450-7044
US

V. Phone/Fax

Practice location:
  • Phone: 203-630-5357
  • Fax: 203-634-7061
Mailing address:
  • Phone: 203-630-5357
  • Fax: 203-634-7061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5688
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: