Provider Demographics
NPI:1417746678
Name:TIBURCIO, VICTORIA (LCSW)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:TIBURCIO
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:GOWDEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1329 JEFFERSON BLVD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2532
Mailing Address - Country:US
Mailing Address - Phone:401-477-9446
Mailing Address - Fax:
Practice Address - Street 1:1329 JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2532
Practice Address - Country:US
Practice Address - Phone:401-477-9446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICSW032871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical