Healthcare Provider Details

I. General information

NPI: 1801684261
Provider Name (Legal Business Name): VICKY ALEJANDRA CONTRERAS MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2025
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1419 SHAKESPEARE AVE
BRONX NY
10452-1851
US

IV. Provider business mailing address

1082 GERARD AVE APT 1A
BRONX NY
10452-8818
US

V. Phone/Fax

Practice location:
  • Phone: 718-732-7080
  • Fax:
Mailing address:
  • Phone: 717-330-0347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: