MEDICARE: VICTORY HEALTH SOLUTION LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1851254783
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VICTORY HEALTH SOLUTION LLC

Provider Business Mailing Address
First Line	:	2337 LAURELWOOD DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-3045
Country	:	US
Telephone Number	:	225-888-4415
Fax Number	:	225-888-4415

Provider Business Practice Location Address
First Line	:	2337 LAURELWOOD DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-3045
Country	:	US
Telephone Number	:	225-888-4415
Fax Number	:	225-888-4415

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	AKAMIN VICTOR NKENGAKA
Credential	:	PH.D., LCSW, LAADC
Telephone Number	:	225-888-4415

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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