Provider Demographics
NPI:1710344668
Name:JAKAB, VIKTOR (LPC)
Entity Type:Individual
Prefix:
First Name:VIKTOR
Middle Name:
Last Name:JAKAB
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 HOWE AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-4122
Mailing Address - Country:US
Mailing Address - Phone:203-208-6282
Mailing Address - Fax:
Practice Address - Street 1:4 RESEARCH DR STE 402
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-6242
Practice Address - Country:US
Practice Address - Phone:203-208-6282
Practice Address - Fax:203-303-9467
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-23
Last Update Date:2023-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002866101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1710344668Medicaid