Provider Demographics
NPI:1851284459
Name:TILLOTSON, VICTORIA (LPC-IT, NCC)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:TILLOTSON
Suffix:
Gender:F
Credentials:LPC-IT, NCC
Other - Prefix:
Other - First Name:VEE
Other - Middle Name:
Other - Last Name:TILLOTSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC-IT, NCC
Mailing Address - Street 1:1245 CHEYENNE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:WI
Mailing Address - Zip Code:53024-9323
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1245 CHEYENNE AVE STE 200
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:WI
Practice Address - Zip Code:53024-9323
Practice Address - Country:US
Practice Address - Phone:715-321-2948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8410-226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health