Provider Demographics
NPI:1164073326
Name:CABRAL, VICTOR ALFONSO (LCSW)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:ALFONSO
Last Name:CABRAL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4512 BOLTON NOTCH PL
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-3414
Mailing Address - Country:US
Mailing Address - Phone:717-400-1871
Mailing Address - Fax:
Practice Address - Street 1:1105 BERKSHIRE BLVD OFC 110
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1248
Practice Address - Country:US
Practice Address - Phone:610-374-4963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-27
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0259701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty