Healthcare Provider Details

I. General information

NPI: 1104552686
Provider Name (Legal Business Name): MS. VICTORIA LEIGH CAREY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2022
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6010 BLACK HORSE PIKE
EGG HARBOR TOWNSHIP NJ
08234-9752
US

IV. Provider business mailing address

312 HARBOUR CV
SOMERS POINT NJ
08244-2802
US

V. Phone/Fax

Practice location:
  • Phone: 609-418-2119
  • Fax:
Mailing address:
  • Phone: 609-335-4013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37PC01237200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: