Healthcare Provider Details

I. General information

NPI: 1255002499
Provider Name (Legal Business Name): VICTORIA NOORDHOEK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TORI NOORDHOEK LICSW

II. Dates (important events)

Enumeration Date: 09/27/2021
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MAIN ST STE 17
MAYNARD MA
01754-2516
US

IV. Provider business mailing address

100 MAIN ST STE 17
MAYNARD MA
01754-2516
US

V. Phone/Fax

Practice location:
  • Phone: 617-213-0384
  • Fax: 781-227-6010
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number000226181
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: