Healthcare Provider Details

I. General information

NPI: 1972357671
Provider Name (Legal Business Name): VICTORIA BARE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VICTORIA BURR

II. Dates (important events)

Enumeration Date: 04/17/2024
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 W CORBETT AVE
SWANSBORO NC
28584-8438
US

IV. Provider business mailing address

722 CEDAR POINT BLVD # 186
CEDAR POINT NC
28584-8012
US

V. Phone/Fax

Practice location:
  • Phone: 910-939-1127
  • Fax:
Mailing address:
  • Phone: 320-292-2871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC020356
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: