Individual provider · NPI-1
Victor Thomas Needham Jr., MA,CRADC,NCC
Psychologist, Family · Park Forest, IL
NPI number1992821656
StatusActive
Last updated in NPPESSep 11, 2025
Details
- NPI
- 1992821656
- Entity type
- Individual (NPI-1)
- Name
- Mr. Victor Thomas Needham Jr.
- Credential
- MA,CRADC,NCC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 22, 2007
- Last updated
- Sep 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TF0000X | Psychologist, Family | – | – | Yes |
| 101Y00000X | Counselor | – | – | |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | |
| 101YM0800X | Counselor, Mental Health | – | – | |
| 103TA0400X | Psychologist, Addiction (Substance Use Disorder) | – | – | |
| 103TC1900X | Psychologist, Counseling | – | – |
Practice location
252 Main StPark Forest, IL 60466-2098
Phone 708-481-9570 · Fax 708-481-9540
Mailing address
105 Warwick StPark Forest, IL 60466-1620
Phone 708-503-8870
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.