Healthcare Provider Details

I. General information

NPI: 1013846559
Provider Name (Legal Business Name): VICTORY COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5137 GOLDEN FOOTHILL PKWY STE 110
EL DORADO HILLS CA
95762-9671
US

IV. Provider business mailing address

5137 GOLDEN FOOTHILL PKWY STE 110
EL DORADO HILLS CA
95762-9671
US

V. Phone/Fax

Practice location:
  • Phone: 530-220-0431
  • Fax:
Mailing address:
  • Phone: 530-220-0431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: AMY BUCHANAN
Title or Position: OWNER
Credential: LCSW
Phone: 530-220-0431