Provider Demographics
NPI:1730201799
Name:WERNER, VICTOR (LPC)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:WERNER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 LEISUREWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-6208
Mailing Address - Country:US
Mailing Address - Phone:501-372-4242
Mailing Address - Fax:501-372-6565
Practice Address - Street 1:7 LEISUREWOOD LN
Practice Address - Street 2:
Practice Address - City:MAUMELLE
Practice Address - State:AR
Practice Address - Zip Code:72113-6208
Practice Address - Country:US
Practice Address - Phone:501-372-4242
Practice Address - Fax:501-372-6565
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP9509027101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health