Provider Demographics
NPI:1669802641
Name:KESSINGER, VICTORIA (LCPC)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:KESSINGER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1526 W THOMAS ST APT 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-8586
Mailing Address - Country:US
Mailing Address - Phone:781-635-0707
Mailing Address - Fax:
Practice Address - Street 1:1526 W THOMAS ST APT 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-8586
Practice Address - Country:US
Practice Address - Phone:781-635-0707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178010946101YP2500X
IL180010904101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional