MEDICARE: VICTORIA CLAIRE MARIEA VASILEFF LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	61144447	WA

General Provider Information

NPI Number	:	1003703166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA CLAIRE MARIEA VASILEFF LMHC

Provider Business Mailing Address
First Line	:	2602 S UNION AVE APT C105
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98405-1308
Country	:	US
Telephone Number	:	618-670-8980
Fax Number	:

Provider Business Practice Location Address
First Line	:	2602 S UNION AVE APT C105
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98405-1308
Country	:	US
Telephone Number	:	618-670-8980
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2025
Last Update Date	:	06/20/2025

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