Individual
MR. VICTOR THOMAS NEEDHAM JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA,CRADC,NCC
Contact information
Practice address
252 MAIN ST, PARK FOREST, IL 60466-2098
(708) 481-9570
(708) 481-9540
Mailing address
105 WARWICK ST, PARK FOREST, IL 60466-1620
(708) 503-8870
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TF0000X
Family Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A10420001A
—
IL
Enumeration date
03/22/2007
Last updated
09/11/2025
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