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General NPI Number Information
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NPI Number | 1629379219
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Entity Type | Organization
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Legal Business Name | VICTORIA ALBANESE, LCSW, LLC
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Dates
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Enumeration Date | 11/12/2010
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Last Update Date | 09/12/2012
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Provider Practice Location Address
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Address Line | 47 GREENSBORO HWY SUITE 3
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City | WATKINSVILLE
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State | GA
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Zip | 30677-2515
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Country | US
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Telephone | 706-338-9685
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Fax | 706-310-7044
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Provider Business Mailing Address
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Address Line | PO BOX 1366
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City | MADISON
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State | GA
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Zip | 30650
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Country | US
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Telephone | 706-338-9685
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Fax | 706-310-7044
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Authorized Official
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Title or Position | OWNER
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Name | MS. VICTORIA BANKOV ALBANESE
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Credential | MSW
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Telephone | 706-338-9685
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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 | CSW0003222
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License Number State | GA
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