Healthcare Provider Details

I. General information

NPI: 1376671925
Provider Name (Legal Business Name): VICTORIA KALDERON LCSW-R
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 02/14/2026
Certification Date: 02/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 PRINCE ST APT 205
NEW YORK NY
10012-2936
US

IV. Provider business mailing address

177 PRINCE ST APT 205
NEW YORK NY
10012-2936
US

V. Phone/Fax

Practice location:
  • Phone: 646-294-3812
  • Fax:
Mailing address:
  • Phone: 646-294-3812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number071627
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: