Provider Demographics
NPI:1669974069
Name:CRAVENS, VICTORIA LYNN (LPC)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:LYNN
Last Name:CRAVENS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22747 SHANNON FALLS CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-2259
Mailing Address - Country:US
Mailing Address - Phone:281-392-3785
Mailing Address - Fax:
Practice Address - Street 1:1832 SNAKE RIVER RD STE E
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-7741
Practice Address - Country:US
Practice Address - Phone:281-740-7563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39906101YA0400X
TX74354101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX74354OtherTEXAS STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS