Provider Demographics
NPI:1912353269
Name:VICTOR, HEDDA (CRC, MHC-LP)
Entity Type:Individual
Prefix:
First Name:HEDDA
Middle Name:
Last Name:VICTOR
Suffix:
Gender:F
Credentials:CRC, MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:843 E 51ST ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-5927
Mailing Address - Country:US
Mailing Address - Phone:917-443-0500
Mailing Address - Fax:
Practice Address - Street 1:27A WASHINGTON PL
Practice Address - Street 2:
Practice Address - City:ROOSEVELT
Practice Address - State:NY
Practice Address - Zip Code:11575-1454
Practice Address - Country:US
Practice Address - Phone:516-623-7741
Practice Address - Fax:516-623-7741
Is Sole Proprietor?:No
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health