Provider Demographics
NPI:1891176012
Name:TSARAN, VICTORIYA (PSYD,LPC)
Entity Type:Individual
Prefix:DR
First Name:VICTORIYA
Middle Name:
Last Name:TSARAN
Suffix:
Gender:F
Credentials:PSYD,LPC
Other - Prefix:
Other - First Name:VICTORIYA
Other - Middle Name:
Other - Last Name:KOGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD, LPC
Mailing Address - Street 1:666 MALLARD LN
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-3630
Mailing Address - Country:US
Mailing Address - Phone:847-791-1580
Mailing Address - Fax:
Practice Address - Street 1:637 E GOLF RD
Practice Address - Street 2:209
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4967
Practice Address - Country:US
Practice Address - Phone:847-791-1580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-12
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178008016103TC0700X
IL071009176103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical