Healthcare Provider Details

I. General information

NPI: 1053893065
Provider Name (Legal Business Name): VICTORIA GORRA LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2018
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 RADISSON PLZ FL 8
NEW ROCHELLE NY
10801-5766
US

IV. Provider business mailing address

4 DEER TRL
FRANKLIN LAKES NJ
07417-2700
US

V. Phone/Fax

Practice location:
  • Phone: 917-270-4577
  • Fax:
Mailing address:
  • Phone: 917-270-4577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number008960
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: