Provider Demographics
NPI:1962843128
Name:CENTER, VICKI (LCSW)
Entity type:Individual
Prefix:
First Name:VICKI
Middle Name:
Last Name:CENTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:VICKI
Other - Middle Name:MAE
Other - Last Name:COSTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:10665 YEAGER AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32145-9412
Mailing Address - Country:US
Mailing Address - Phone:443-553-0335
Mailing Address - Fax:
Practice Address - Street 1:10665 YEAGER AVE
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:FL
Practice Address - Zip Code:32145-9412
Practice Address - Country:US
Practice Address - Phone:443-553-0335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-16
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-0000824104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker