Provider Demographics
NPI:1548548183
Name:VIC TORGRIMSEN, LCSW PLLC
Entity type:Organization
Organization Name:VIC TORGRIMSEN, LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:W
Authorized Official - Last Name:TORGRIMSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:631-766-7470
Mailing Address - Street 1:85 MIDWAY ST
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-4311
Mailing Address - Country:US
Mailing Address - Phone:631-766-7470
Mailing Address - Fax:631-661-1951
Practice Address - Street 1:170 LITTLE EAST NECK RD
Practice Address - Street 2:SUITE 02
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-7742
Practice Address - Country:US
Practice Address - Phone:631-766-7170
Practice Address - Fax:631-661-1951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-01
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078548-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty