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General NPI Number Information
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NPI Number | 1003557547
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Entity Type | Organization
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Legal Business Name | VICTORIOUS COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 04/06/2022
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Last Update Date | 04/06/2022
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Provider Practice Location Address
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Address Line | 99 DERBY ST STE 200
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City | HINGHAM
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State | MA
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Zip | 02043-4216
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Country | US
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Telephone | 617-379-1464
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Fax |
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Provider Business Mailing Address
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Address Line | 75 DONALD ST APT 12
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City | WEYMOUTH
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State | MA
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Zip | 02188-3920
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Country | US
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Telephone | 617-379-1464
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | NIKOLAS R PROTASENIA
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Credential | LMHC
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Telephone | 617-379-1464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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