Provider Demographics
NPI:1114086279
Name:ADLER, VICKY LYNN (LPC,LMFT)
Entity Type:Individual
Prefix:MRS
First Name:VICKY
Middle Name:LYNN
Last Name:ADLER
Suffix:
Gender:F
Credentials:LPC,LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4709 CONSTANCE ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-5242
Mailing Address - Country:US
Mailing Address - Phone:361-850-7850
Mailing Address - Fax:361-993-7043
Practice Address - Street 1:6000 S STAPLES ST STE 406
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-2952
Practice Address - Country:US
Practice Address - Phone:361-980-8005
Practice Address - Fax:361-993-7043
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX09601101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health