Doctor Name: | MR. VICTOR THOMAS NEEDHAM |
NPI Number: | 1992821656 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MA,CRADC,NCC |
License Number: | |
Business Practice Address: | 252 Main St Park Forest, IL - 604662098 |
Business Phone Number: | 7084819570 |
Business Fax Number: | 7084819540 |
Mailing Address: | 105 Warwick St, PARK FOREST |
State: | IL |
Postal Code: | 604661620 |
Phone Number: | 7085038870 |
Fax Number: | |
NPI Enumeration Date: | 03/22/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |