Victoria Cullen, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.018924 Issued in IL

Practice address

40B Edwardsville Prof Park
Edwardsville, IL 62025-3602

Phone

(618) 248-2040

Fax

(618) 248-2040

NPI assigned

Jan 17, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Victoria Kaase Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Radzom Counseling LLC

  • Clinical Social Worker
  • Edwardsville, IL
  • NPI 1639462948
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1003352865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 101",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620250101",
            "telephone_number": "618-248-2040",
            "fax_number": "618-248-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40B EDWARDSVILLE PROF PARK",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253602",
            "telephone_number": "618-248-2040",
            "fax_number": "618-248-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLEN",
        "first_name": "VICTORIA",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-17",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2016043701",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.018924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "KAASE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Palmer Crum, LCPC, LPC
• Kortlyn Elizabeth Cruz
• Crystal Heart Healing PLLC
• Danielle R Csaszar, DMD
• Chad Franco Cuconato, RN
• Thea Ranee Cyr, RN
• Gerardo D'Amato, RBT
• Jenna Dallman
• David Darrow, SRNA
• Davey Professional Services LLC

• Clinical Social Worker in Edwardsville, IL
• Providers in Edwardsville, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.