Provider Demographics
NPI:1124264270
Name:LOFTISS, VICTOR RIGGS (LPC)
Entity type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:RIGGS
Last Name:LOFTISS
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 1:3114 AUGUSTA TECH DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30906-3300
Mailing Address - Country:US
Mailing Address - Phone:706-830-8459
Mailing Address - Fax:
Practice Address - Street 1:3114 AUGUSTA TECH DR
Practice Address - Street 2:SUITE 102
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-3300
Practice Address - Country:US
Practice Address - Phone:706-830-8459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-19
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003176101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor