Provider Demographics
NPI:1114519881
Name:NELSON, VICTORIA (MSW,LMSW)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:MSW,LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 E 117TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64134-3701
Mailing Address - Country:US
Mailing Address - Phone:816-554-5549
Mailing Address - Fax:
Practice Address - Street 1:200 NE MISSOURI RD STE 307
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-4722
Practice Address - Country:US
Practice Address - Phone:816-839-9427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-04
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20240309091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical