Healthcare Provider Details

I. General information

NPI: 1194655621
Provider Name (Legal Business Name): VICTORIA CHRISTIAN TAYLOR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2244 EXECUTIVE DR
HAMPTON VA
23666-2430
US

IV. Provider business mailing address

5109 GOLDSBORO DR APT 5F
HAMPTON VA
23605-1323
US

V. Phone/Fax

Practice location:
  • Phone: 757-827-3124
  • Fax:
Mailing address:
  • Phone: 757-951-3262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904020304
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: