Individual
DR. MARISA HELENA VICTORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D., MA, MSW
Contact information
Practice address
2100 N MAIN ST STE 304, CROWN POINT, IN 46307-1877
(745) 461-9005
(574) 546-1999
Mailing address
5314 LAUREL CREST RUN, NOBLESVILLE, IN 46062-7435
(317) 678-0998
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20043650B
IN
103TC0700X
Clinical Psychologist
39154
TX
103TC0700X
Clinical Psychologist
P.08524
OH
1041C0700X
Clinical Social Worker
I.1201235
OH
1041C0700X
Clinical Social Worker
S.0901121
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P.085240
STATE LICENSE
OH
Enumeration date
03/24/2010
Last updated
12/09/2024
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