Individual provider Active NPI

Eric Timothy Victorino, LMHC, LPC

  • Mental Health Counselor
  • Watertown, NY
National Provider Identifier
1508458944
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
013778-01 Issued in NY
Practice address
1222 Arsenal St
Watertown, NY 13601-2297
Phone
(315) 425-4400
NPI assigned
Feb 8, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 006747 CT
Mental Health Counselor 101YM0800X 013778-01 NY Primary

Addresses

Primary practice location

1222 Arsenal St
Watertown, NY 13601-2297

Mailing address

12868 House Rd
Clayton, NY 13624-3173
Phone (315) 955-9583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
013778-01NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1508458944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12868 HOUSE RD",
            "city": "CLAYTON",
            "state": "NY",
            "postal_code": "136243173",
            "telephone_number": "315-955-9583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 ARSENAL ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012297",
            "telephone_number": "315-425-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICTORINO",
        "first_name": "ERIC",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "LMHC, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-08",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "006747",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "013778-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; 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.