Provider Demographics
NPI:1871630020
Name:FOLSE, VICTORIA N (PHD, APN, LCPC)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:N
Last Name:FOLSE
Suffix:
Gender:F
Credentials:PHD, APN, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 E MONROE ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61701-3328
Mailing Address - Country:US
Mailing Address - Phone:309-678-5361
Mailing Address - Fax:309-556-3043
Practice Address - Street 1:1121 E MONROE ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61701-3328
Practice Address - Country:US
Practice Address - Phone:309-678-5361
Practice Address - Fax:309-556-3043
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180000671101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health