Active NPI
Jason Robert Victory, MS, NCC, LPC, ACS
- Professional Counselor
- Durham, NC
National Provider Identifier
1538432687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PC003817
- Practice address
- 115 Market St Ste 470
Durham, NC 27701-3241 - Phone
- (336) 740-9693
- Fax
- (919) 797-2644
- NPI assigned
- Feb 21, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PC003817 | PA | Primary |
Addresses
Primary practice location
115 Market St Ste 470
Durham, NC 27701-3241
Mailing address
115 Market St Ste 470
Durham, NC 27701-3241
Phone (336) 740-9693
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PC003817 | PA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329782400000",
"number": "1538432687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 MARKET ST STE 470",
"city": "DURHAM",
"state": "NC",
"postal_code": "277013241",
"telephone_number": "336-740-9693",
"fax_number": "919-797-2644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 MARKET ST STE 470",
"city": "DURHAM",
"state": "NC",
"postal_code": "277013241",
"telephone_number": "336-740-9693",
"fax_number": "919-797-2644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VICTORY",
"first_name": "JASON",
"middle_name": "ROBERT",
"name_prefix": "Mr.",
"credential": "MS, NCC, LPC, ACS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-02-21",
"last_updated": "2012-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC003817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.