Victoria Jean-Maxin Lofgren

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6451017782 Issued in MI

Practice address

24715 Little Mack Ave Ste 200
Saint Clair Shores, MI 48080-3207

Phone

(586) 777-0942

NPI assigned

Mar 29, 2018

Last updated

Nov 16, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Miss Victoria Jean Maxin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: lifestancehealth.victoriamaxinlofgren@150339.advancedmd-direct.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1962907949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24715 LITTLE MACK AVE STE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480803207",
            "telephone_number": "586-777-0942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24715 LITTLE MACK AVE STE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480803207",
            "telephone_number": "586-777-0942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOFGREN",
        "first_name": "VICTORIA",
        "middle_name": "JEAN-MAXIN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6451017782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "MAXIN",
            "middle_name": "JEAN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lip Therapy and Counseling
• Melissa Lipari, PHARM.D.
• Miche'Le Giorgio Lipari
• Zachary Jonathan Liss, M.D.
• Living Out Loud
• Victoria Marie Loft, M.D
• Erika Lombardo, ATC, PTA
• Jennifer Lombardo, PA
• Hannah Christine Long
• Valerie Ilene Kvale Long, PH.D.

• Professional Counselor in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.