Provider Demographics
NPI:1194071746
Name:POSPISIL, VICTORIA ANNE (LMHC)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:ANNE
Last Name:POSPISIL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4670 LIPSCOMB ST NE
Mailing Address - Street 2:STE. 11
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-2927
Mailing Address - Country:US
Mailing Address - Phone:321-726-2889
Mailing Address - Fax:321-726-2893
Practice Address - Street 1:4670 LIPSCOMB ST NE
Practice Address - Street 2:STE. 11
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-2927
Practice Address - Country:US
Practice Address - Phone:321-726-2889
Practice Address - Fax:321-726-2893
Is Sole Proprietor?:No
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 10756101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health