Provider Demographics
NPI:1285764969
Name:MULVEY, VICTORIA A (LMHC)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:A
Last Name:MULVEY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 EVERGREEN CT
Mailing Address - Street 2:
Mailing Address - City:EAST QUOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11942-4422
Mailing Address - Country:US
Mailing Address - Phone:631-728-5723
Mailing Address - Fax:
Practice Address - Street 1:6 EVERGREEN CT
Practice Address - Street 2:
Practice Address - City:EAST QUOGUE
Practice Address - State:NY
Practice Address - Zip Code:11942-4422
Practice Address - Country:US
Practice Address - Phone:631-728-5723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY#000744174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist