Healthcare Provider Details

I. General information

NPI: 1821491341
Provider Name (Legal Business Name): VICTORIA LEY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2014
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 LAFAYETTE ST
RIVERSIDE NJ
08075-3120
US

IV. Provider business mailing address

612 W BROOKE AVE
MAGNOLIA NJ
08049-1108
US

V. Phone/Fax

Practice location:
  • Phone: 856-661-1100
  • Fax:
Mailing address:
  • Phone: 609-351-6245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06443200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: