Provider Demographics
NPI:1023281318
Name:WOODS, VICTORIA L (LCSW)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:L
Last Name:WOODS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:TORI
Other - Middle Name:
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 1291
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85547-1291
Mailing Address - Country:US
Mailing Address - Phone:602-679-5273
Mailing Address - Fax:602-216-9590
Practice Address - Street 1:814 N. BEELINE HWY
Practice Address - Street 2:SUITE E
Practice Address - City:PAYSON
Practice Address - State:AZ
Practice Address - Zip Code:85541-3757
Practice Address - Country:US
Practice Address - Phone:602-679-5273
Practice Address - Fax:602-216-9590
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW117491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ017583Medicaid