Provider Demographics
NPI:1831761261
Name:PEYTON, VICTORIA MAE (LCSW)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:MAE
Last Name:PEYTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:M
Other - Last Name:HOLT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2108 WATERBURY LN E
Mailing Address - Street 2:
Mailing Address - City:SYCAMORE
Mailing Address - State:IL
Mailing Address - Zip Code:60178-3031
Mailing Address - Country:US
Mailing Address - Phone:312-405-7435
Mailing Address - Fax:
Practice Address - Street 1:2600 DEKALB AVE
Practice Address - Street 2:
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178-3131
Practice Address - Country:US
Practice Address - Phone:815-787-9000
Practice Address - Fax:815-787-9015
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0079321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical