Needham, Victor Thomas
Needham, Victor Thomas is an sole proprietor health care provider with primary practice located at 252 Main St , Park Forest IL 60466-2098. He recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Family. Behavioral Health & Social Service Providers / Counselor is his primary health care specialty. Needham, Victor Thomas can be contacted via phone (708) 481-9570.Contact Information
Primary practice address
252 Main St
Park Forest IL 60466-2098
Phone: (708) 481-9570
Fax: (708) 481-9540
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X | ||
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | ||
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | ||
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 103TA0400X | ||
| Behavioral Health & Social Service Providers / Counseling | 103TC1900X | ||
| Behavioral Health & Social Service Providers / Family | 103TF0000X |
Profile Details
| NPI number | 1992821656 |
|---|---|
| LBN Legal business name | Needham, Victor Thomas |
| Credentials | MA,CRADC,NCC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 22nd, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992821656 | NPPES |
| Illinois | MEDICAID | A10420001A |
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