Provider Demographics
NPI:1508072489
Name:FRUE, VICTORIA (MS, LPC, NCC, CSAT)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:FRUE
Suffix:
Gender:F
Credentials:MS, LPC, NCC, CSAT
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:ACTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6402 ODANA RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719
Mailing Address - Country:US
Mailing Address - Phone:828-301-0097
Mailing Address - Fax:828-298-4870
Practice Address - Street 1:6402 ODANA RD.
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719
Practice Address - Country:US
Practice Address - Phone:828-301-0097
Practice Address - Fax:828-298-4870
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12537101YM0800X, 101YP2500X
WI2581-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI208013972OtherTAX I.D.