| Doctor Name: | DR. VICKI VAN CLEAVE |
| NPI Number: | 1134330574 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSYD |
| License Number: | 0810003638 |
| Business Practice Address: | 132 Pearl Ave Campbellsville, KY - 42718 |
| Business Phone Number: | 8042454311 |
| Business Fax Number: | 5403502902 |
| Mailing Address: | 132 Pearl Ave, CAMPBELLSVILLE |
| State: | KY |
| Postal Code: | 42718 |
| Phone Number: | 8042454311 |
| Fax Number: | 5403502902 |
| NPI Enumeration Date: | 05/25/2007 |
| NPI Last Update Date: | 05/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 0810003638 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |