Provider Demographics
NPI:1790912517
Name:AILEY-ROBERSON, VICKI (LMHC, ACADC)
Entity Type:Individual
Prefix:MS
First Name:VICKI
Middle Name:
Last Name:AILEY-ROBERSON
Suffix:
Gender:F
Credentials:LMHC, ACADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 SW PLAZA SHOPS LN STE D
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-7168
Mailing Address - Country:US
Mailing Address - Phone:515-508-1150
Mailing Address - Fax:866-473-0770
Practice Address - Street 1:1138 SE MILL POND CT
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50021-6544
Practice Address - Country:US
Practice Address - Phone:515-508-1150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00918101YM0800X
IA96051101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)