Healthcare Provider Details

I. General information

NPI: 1043846777
Provider Name (Legal Business Name): VICTORIA ANN MCCANN LMHC. PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VICTORIA ANN JOHNSON LMHC

II. Dates (important events)

Enumeration Date: 03/13/2020
Last Update Date: 06/20/2022
Certification Date: 06/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 SW FEDERAL HWY STE 200B
STUART FL
34994-2952
US

IV. Provider business mailing address

5879 SE MITZI LN
STUART FL
34997-8006
US

V. Phone/Fax

Practice location:
  • Phone: 772-486-9297
  • Fax:
Mailing address:
  • Phone: 561-232-8238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH17895
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: