Basic Information
| Provider Information | |||||||||
| NPI: | 1871561316 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SANTOS | ||||||||
| FirstName: | VICKI | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MSW, LISW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2550 KENLO WOODS DR | ||||||||
| Address2: | |||||||||
| City: | NASHPORT | ||||||||
| State: | OH | ||||||||
| PostalCode: | 438309756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7404542887 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2845 BELL ST | ||||||||
| Address2: | |||||||||
| City: | ZANESVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 437011720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7404549766 | ||||||||
| FaxNumber: | 7405886452 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | I585 | OH | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 000000218888 | 01 | OH | ANTHEM PIN | OTHER | Y301535 | 01 | OH | THE HEALTH PLAN PIN | OTHER | 212242 | 01 | OH | TRICARE/MHN PIN | OTHER | 129602 | 01 | OH | MOUNT CARMEL PIN (2) | OTHER | 6240602 | 01 | OH | UBH PIN | OTHER | 129601 | 01 | OH | MOUNT CARMEL PIN | OTHER | 2032242 | 01 | OH | CIGNA BH PIN | OTHER | 3733 | 01 | OH | FEI BH PIN | OTHER | 5137561 | 01 | OH | AETNA PIN | OTHER | 9071400 | 01 | OH | PRIVATE HLTHCARE SYS PIN | OTHER | 142338 | 01 | OH | COMPSYCH BH PIN | OTHER |