Healthcare Provider Details

I. General information

NPI: 1720111933
Provider Name (Legal Business Name): VICTORIA SERRANO L.P.C.C. L.C.A.D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 ZORN AVENUE # 52
LOUISVILLE KY
40206
US

IV. Provider business mailing address

720 ZORN AVENUE # 52
LOUISVILLE KY
40206
US

V. Phone/Fax

Practice location:
  • Phone: 502-810-4772
  • Fax:
Mailing address:
  • Phone: 502-810-4772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number120007
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number165648
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: