MEDICARE: VICTORIA SPENSER-NICHOLAS GREY LCSW

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	1041C0700X	Clinical Social Worker	CSW.09927527	CO

General Provider Information

NPI Number	:	1295259950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA SPENSER-NICHOLAS GREY LCSW

Provider Business Mailing Address
First Line	:	425 W MULBERRY ST STE 107
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-2864
Country	:	US
Telephone Number	:	720-365-4497
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 W MULBERRY ST STE 107
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-2864
Country	:	US
Telephone Number	:	720-365-4497
Fax Number	:

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

Provider Enumeration Date	:	08/02/2017
Last Update Date	:	06/11/2025

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