Provider Demographics
NPI:1104357789
Name:SOMMERS, VICTOR KYLE (LPC)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:KYLE
Last Name:SOMMERS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5003 WILLOW POINT DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77303-3078
Mailing Address - Country:US
Mailing Address - Phone:936-668-1900
Mailing Address - Fax:
Practice Address - Street 1:504 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-6027
Practice Address - Country:US
Practice Address - Phone:936-668-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-24
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69115101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health