Healthcare Provider Details

I. General information

NPI: 1801449087
Provider Name (Legal Business Name): VICTORIA ANNE WESTBROOK LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2019
Last Update Date: 07/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8207 CALLAGHAN RD STE 425
SAN ANTONIO TX
78230-4737
US

IV. Provider business mailing address

8207 CALLAGHAN RD
SAN ANTONIO TX
78230-4735
US

V. Phone/Fax

Practice location:
  • Phone: 210-366-3700
  • Fax: 210-265-1442
Mailing address:
  • Phone: 210-366-3700
  • Fax: 210-265-1442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number76570
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: