Provider Demographics
NPI:1083192629
Name:PRIKHODKO, NAYMAR VICTORIA (LBSW)
Entity Type:Individual
Prefix:
First Name:NAYMAR
Middle Name:VICTORIA
Last Name:PRIKHODKO
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:NAYMAR
Other - Middle Name:VICTORIA
Other - Last Name:UZCATEGUI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1504 HAMILTONS WAY
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-3580
Mailing Address - Country:US
Mailing Address - Phone:512-736-2080
Mailing Address - Fax:
Practice Address - Street 1:1504 HAMILTONS WAY
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-3580
Practice Address - Country:US
Practice Address - Phone:512-736-2080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-06
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator