Healthcare Provider Details

I. General information

NPI: 1245067149
Provider Name (Legal Business Name): VICTORIOUS HEALING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2024
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7331 W CHARLESTON BLVD STE 140
LAS VEGAS NV
89117-1570
US

IV. Provider business mailing address

PO BOX 335122
NORTH LAS VEGAS NV
89033-5122
US

V. Phone/Fax

Practice location:
  • Phone: 702-238-1437
  • Fax: 702-552-5755
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: BREONDA J DIXON
Title or Position: OWNER
Credential: LCPC
Phone: 702-283-1437