Provider Demographics
NPI:1487176632
Name:BAKER, VICTORIA VITULLO (MA, CRC, LPC)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:VITULLO
Last Name:BAKER
Suffix:
Gender:F
Credentials:MA, CRC, LPC
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:VITULLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, CRC, LPC
Mailing Address - Street 1:45 HENNIG DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-1567
Mailing Address - Country:US
Mailing Address - Phone:412-956-4500
Mailing Address - Fax:
Practice Address - Street 1:45 HENNIG DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236-1567
Practice Address - Country:US
Practice Address - Phone:412-956-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-10
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
PAPC005271101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health