Healthcare Provider Details

I. General information

NPI: 1669154969
Provider Name (Legal Business Name): VICTORIA OLIVIA PAYAN LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VICTORIA OLIVIA WINDSOR LAPC

II. Dates (important events)

Enumeration Date: 08/04/2023
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4205 STATE STREET SUITE 5
BISMARCK ND
58503
US

IV. Provider business mailing address

4205 STATE STREET SUITE 5
BISMARCK ND
58503
US

V. Phone/Fax

Practice location:
  • Phone: 701-937-4695
  • Fax: 701-248-9315
Mailing address:
  • Phone: 701-937-4695
  • Fax: 701-248-9315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1314-8-1-23A
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: