Provider Demographics
NPI:1225332059
Name:HERBERT, VICTORIA L (MA LCPC)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:L
Last Name:HERBERT
Suffix:
Gender:F
Credentials:MA LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3809 N CLAREMONT AVE # 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-3817
Mailing Address - Country:US
Mailing Address - Phone:773-343-7650
Mailing Address - Fax:
Practice Address - Street 1:3809 N CLAREMONT AVE # 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-3817
Practice Address - Country:US
Practice Address - Phone:773-343-7650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-10
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.006939101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional