Provider Demographics
NPI:1265426472
Name:HAAG, VICTORIA J (LCMFT)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:J
Last Name:HAAG
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:518 MONTANA AVE
Mailing Address - Street 2:
Mailing Address - City:HOLTON
Mailing Address - State:KS
Mailing Address - Zip Code:66436-1142
Mailing Address - Country:US
Mailing Address - Phone:785-851-4343
Mailing Address - Fax:316-768-4145
Practice Address - Street 1:104 W 5TH ST STE 8
Practice Address - Street 2:
Practice Address - City:HOLTON
Practice Address - State:KS
Practice Address - Zip Code:66436-1788
Practice Address - Country:US
Practice Address - Phone:785-851-4343
Practice Address - Fax:316-768-4145
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-01
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS102106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS481191048001OtherTRICARE WEST REGION
KS6293357OtherUNITED BEHAVIORAL HEALTH
KS0204835OtherCOMPSYCH
KS14146673OtherWAUSAU
KS373248OtherBLUE CROSS BLUE SHIELD
KS024436OtherVMC BEHAVIORAL HEALTH
KS188092OtherMANAGED HEALTH NETWORK
KS2022246OtherCIGNA BEHAVIORAL HEALTH
KS200429060CMedicaid
KS220944OtherVALUE OPTIONS