MEDICARE: DR. VICTORIA DOREE COLEMAN ED.D.

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	101YP2500X	Professional Counselor	180.008854	IL
2	101YM0800X	Mental Health Counselor	CP0164	NV
3	101YP2500X	Professional Counselor	CP0164	NV
4	133NN1002X	Nutrition Education Nutritionist
5	1744R1102X	Research Study Specialist
6	106H00000X	Marriage & Family Therapist	35000688A	IN
7	101YA0400X	Addiction (Substance Use Disorder) Counselor	17914
8	175L00000X	Homeopath
9	1041C0700X	Clinical Social Worker	34002388A	IN
10	103TC1900X	Counseling Psychologist
11	101YP2500X	Professional Counselor	976	CA
12	175F00000X	Naturopath
13	101YP2500X	Professional Counselor	6401000417	MI

General Provider Information

NPI Number	:	1932315447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICTORIA DOREE COLEMAN ED.D.

Provider Business Mailing Address
First Line	:	9811 W CHARLESTON BLVD
Second Line	:	SUITE 2-376
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7528
Country	:	US
Telephone Number	:	702-220-5300
Fax Number	:	708-405-4105

Provider Business Practice Location Address
First Line	:	9811 W CHARLESTON BLVD
Second Line	:	SUITE 2-376
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7528
Country	:	US
Telephone Number	:	702-220-5300
Fax Number	:	708-405-4105

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	11/27/2025

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