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General NPI Number Information
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NPI Number | 1306965363
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Entity Type | Individual
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Provider Name | VICTORIA ROSE JOHNSON LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 10/26/2011
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Provider Practice Location Address
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Address Line | 333 OLD HOOK RD SUITE 102
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City | WESTWOOD
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State | NJ
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Zip | 07675-3200
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Country | US
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Telephone | 973-557-1679
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Fax | 201-664-5010
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Provider Business Mailing Address
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Address Line | 211 CLINTON AVE
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City | CLIFTON
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State | NJ
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Zip | 07011-3307
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Country | US
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Telephone | 973-778-4518
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05331200
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License Number State | NJ
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