Provider Demographics
NPI:1366246456
Name:SPENCER, VICTORIA AMANDA
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:AMANDA
Last Name:SPENCER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 LINCOLN AVE APT 114
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07050-2246
Mailing Address - Country:US
Mailing Address - Phone:973-771-9092
Mailing Address - Fax:973-771-9092
Practice Address - Street 1:2825 3RD AVE STE 402
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-4073
Practice Address - Country:US
Practice Address - Phone:718-520-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health