Healthcare Provider Details

I. General information

NPI: 1043182314
Provider Name (Legal Business Name): VICTORIA OBLISK LPCC, LICDC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2025
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 W BOWERY ST
AKRON OH
44308-1069
US

IV. Provider business mailing address

102 MAIN ST STE 304
WADSWORTH OH
44281-1434
US

V. Phone/Fax

Practice location:
  • Phone: 330-543-5015
  • Fax:
Mailing address:
  • Phone: 330-778-8961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLICDC.162937
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.2606663
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: