Provider Demographics
NPI:1164605457
Name:ISLER, VICTOR ROBOAM (P-LCSW)
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:ROBOAM
Last Name:ISLER
Suffix:
Gender:M
Credentials:P-LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7910 HERNDON RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-9780
Mailing Address - Country:US
Mailing Address - Phone:336-577-1802
Mailing Address - Fax:
Practice Address - Street 1:7910 HERNDON RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-9780
Practice Address - Country:US
Practice Address - Phone:336-577-1802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-10
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0062491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical