Organization Active NPI

Victory Behavioral Health Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1205524980
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
VICTORY BEHAVIORAL HEALTH SERVICES LLC
Practice address
260 Peachtree St NW Ste 2200
Atlanta, GA 30303-1292
Phone
(770) 895-0573
NPI assigned
May 1, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Clara Uguwibe-Ogunseye
Title
Manager
Phone
(770) 895-0573

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0800X
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

260 Peachtree St NW Ste 2200
Atlanta, GA 30303-1292

Mailing address

4350 Huntcliff Trce
Douglasville, GA 30135-8428
Phone (770) 895-0573

Other names 1

  • Victory Behavioral Health Services LLC Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1682899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682899200000",
    "number": "1205524980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 HUNTCLIFF TRCE",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301358428",
            "telephone_number": "770-895-0573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 PEACHTREE ST NW STE 2200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303031292",
            "telephone_number": "770-895-0573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY BEHAVIORAL HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-01",
        "last_updated": "2023-05-01",
        "certification_date": "2023-04-29",
        "status": "A",
        "authorized_official_last_name": "UGUWIBE-OGUNSEYE",
        "authorized_official_first_name": "CLARA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "770-895-0573"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Victory Behavioral Health Services LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.