Provider Demographics
NPI:1104363043
Name:MCANDREW, VICTORIA LOUISE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:LOUISE
Last Name:MCANDREW
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3317 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-2243
Mailing Address - Country:US
Mailing Address - Phone:708-634-6734
Mailing Address - Fax:
Practice Address - Street 1:3317 W 95TH ST
Practice Address - Street 2:
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2243
Practice Address - Country:US
Practice Address - Phone:708-634-6734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.011072101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional