Healthcare Provider Details

I. General information

NPI: 1639088834
Provider Name (Legal Business Name): VICTORIA WEST LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 GETTYSBURG RD STE 106
CAMP HILL PA
17011-7202
US

IV. Provider business mailing address

12 WHITE OAK BLVD
MECHANICSBURG PA
17050-7929
US

V. Phone/Fax

Practice location:
  • Phone: 717-204-8883
  • Fax:
Mailing address:
  • Phone: 717-343-1111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW128862
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: