Healthcare Provider Details
I. General information
NPI: 1487251435
Provider Name (Legal Business Name): VICTORIA LYNN BUSBY
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/02/2020
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
630 PETER JEFFERSON PKWY STE 130
CHARLOTTESVILLE VA
22911-4624
US
IV. Provider business mailing address
630 PETER JEFFERSON PKWY STE 130
CHARLOTTESVILLE VA
22911-4624
US
V. Phone/Fax
- Phone: 434-448-3921
- Fax:
- Phone: 434-448-3921
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 0904019332 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 13543764-3501 |
| License Number State | UT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: