Provider Demographics
NPI:1942193081
Name:ANDERSEN, VICTORIA (MS)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:
Last Name:ANDERSEN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:989 RESERVOIR AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-5138
Mailing Address - Country:US
Mailing Address - Phone:401-321-4423
Mailing Address - Fax:401-638-1740
Practice Address - Street 1:989 RESERVOIR AVE STE 203
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-5138
Practice Address - Country:US
Practice Address - Phone:401-444-7888
Practice Address - Fax:401-638-1740
Is Sole Proprietor?:No
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health