Victoria R Lavick-Scudder, LCPC
Individual provider Active NPI Mental Health Counselor · Mapleton, IL
NPI 1225498389 · NPPES record last updated Jun 26, 2024
Key facts
- NPI
- 1225498389
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 180.007740 (IL)
- Practice address
- 8801 W. Pfeiffer Rd
Mapleton, IL 61547 - Phone
- (309) 550-9903
- Fax
- (800) 554-2401
- NPI assigned
- Mar 2, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 1997
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
7272 Wurzbach Rd
Suite 601
San Antonio, TX 78240-4803
8801 W Pfeiffer Rd
Mapleton, IL 61547-9481
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251020000001 | IL | Practitioner - Mental Health Counselor | 9234627696 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25060 | IL | MD | Addiction (Substance Use Disorder) Counselor |
| 27266 | IL | MD | Addiction (Substance Use Disorder) Counselor |
| 180.007740 | IL | MD | Mental Health Counselor |
| 180007740 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deer Oaks Mid-West LLC | Current |
Accepting new patients |
Locations
720 Raymond Dr
Naperville, IL 60563
Phone (630) 355-0220
7272 Wurzbach Rd
Ste 601
San Antonio, TX 78240
Phone (210) 615-3472
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 180.007740 | IL | Yes |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 25060 | IL | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 27266 | IL | |
| Professional Counselor | 101YP2500X | 180007740 | IL |
Addresses
Primary practice location
8801 W. Pfeiffer Rd
Mapleton, IL 61547
Mailing address
8801 W. Pfeiffer Rd
Mapleton, IL 61547
Phone (309) 550-9903
Other names
- Victoria R Lavick
Other providers in Mapleton, IL
- Delayne L Deiss
- Briana Fletcher
- Alison Goley
- Jeffrey W Hemp
- Abigail Elizabeth Henry
- Rhiannon L Richards
- James Reuben Seavey Jr.
- Kara Sylvester
- Ciela Tamayo
All providers in Mapleton, IL · Mental Health Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.