Provider Demographics
NPI:1922837046
Name:INCERTI, VICTOR (LPC)
Entity type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:
Last Name:INCERTI
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 1:1328 WILEY ST APT 303
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33019-2237
Mailing Address - Country:US
Mailing Address - Phone:860-508-9312
Mailing Address - Fax:
Practice Address - Street 1:1328 WILEY ST APT 303
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33019-2237
Practice Address - Country:US
Practice Address - Phone:860-508-9312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000023101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional