Provider Demographics
NPI:1952076846
Name:VAN FLEET, VICTOR VINCENT (LIMHP, LMHP, CPC)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:VINCENT
Last Name:VAN FLEET
Suffix:
Gender:M
Credentials:LIMHP, LMHP, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 W NORFOLK AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5057
Mailing Address - Country:US
Mailing Address - Phone:402-371-5310
Mailing Address - Fax:402-371-7483
Practice Address - Street 1:1001 W NORFOLK AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-5057
Practice Address - Country:US
Practice Address - Phone:402-371-5310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2557101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health