Alicia a Victory, PSYD, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3279 Issued in TN

Legal business name

ALICIA A VICTORY, PSYD, LLC

Practice address

101 Walnut LN
Columbia, TN 38401

Phone

(615) 625-2117

Fax

(865) 246-2104

NPI assigned

Jul 3, 2018

Last updated

Sep 4, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alicia A Victory, PSYDNPI 1659541969

Title

Owner

Phone

(615) 625-2117

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alicia Anne Victory, PSY.D.

  • Clinical Psychologist
  • Columbia, TN
  • NPI 1659541969
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536019200000",
    "number": "1386130292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5777",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378025777",
            "telephone_number": "865-246-2104",
            "fax_number": "865-246-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WALNUT LN",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "38401",
            "telephone_number": "615-625-2117",
            "fax_number": "865-246-2104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALICIA A VICTORY, PSYD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-03",
        "last_updated": "2018-09-04",
        "status": "A",
        "authorized_official_last_name": "VICTORY",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-625-2117",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "3279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Dale Alden III, PH.D.
• Kristin Nicole Aldridge
• Tessa Reanne Aldridge
• Angela A Alexander, APRN
• Fathi Idris Ali, M.D.
• Caroline Whitlow Allen, M.S., CCC-SLP
• Lawrence Allen
• Robert Allen, PT
• Tanya Allen, LPN
• Elizabeth Kay Alonso, B.S.

• Clinical Psychologist in Columbia, TN
• Providers in Columbia, TN by specialty
• Clinical Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.