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1154649036 NPI number — VICTOR ISAAC MILBERG R.PH LMSW LCSW

NPI Number: 1154649036
Health Care Provider/Practitioner: VICTOR ISAAC MILBERG R.PH LMSW LCSW

Information about “1154649036” NPI (VICTOR ISAAC MILBERG R.PH LMSW LCSW) exists in 1154649036 in HTML format HTML  |  1154649036 in plain Text format TXT  |  1154649036 in PDF (Portable Document Format) PDF  |  1154649036 in an XML format XML  formats.

NPI Number : 1154649036 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1154649036",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MILBERG",
    "FirstName": "VICTOR",
    "MiddleName": "ISAAC",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "R.PH LMSW LCSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "403 BELMONT ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WORCESTER",
    "MailingAddressStateName": "MA",
    "MailingAddressPostalCode": "01604-1019",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "403 BELMONT ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WORCESTER",
    "PracticeLocationAddressStateName": "MA",
    "PracticeLocationAddressPostalCode": "01604-1019",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "413-463-1745",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/17/2010",
    "LastUpdateDate": "07/25/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "183500000X",
          "TaxonomyName": "Pharmacist",
          "LicenseNumber": "045716",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "121752",
          "LicenseNumberStateCode": "MA",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "104100000X",
          "TaxonomyName": "Social Worker",
          "LicenseNumber": "076701",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "008474",
          "LicenseNumberStateCode": "CT",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "081686",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "LC23535",
          "LicenseNumberStateCode": "ME",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "72878",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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