Provider Demographics
NPI:1588818660
Name:BRANDT, VICTORIA (LMHC)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:BRANDT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:VICKY
Other - Middle Name:
Other - Last Name:REICHERT-FACILIDES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:255 ELM ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-2947
Mailing Address - Country:US
Mailing Address - Phone:617-702-9131
Mailing Address - Fax:
Practice Address - Street 1:255 ELM ST STE 201
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-2947
Practice Address - Country:US
Practice Address - Phone:617-702-9131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-16
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6495101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health