Victory Clinical Services

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

VICTORY CLINICAL SERVICES

Practice address

3300 Lansing Ave
Jackson, MI 49202-1621

Phone

(517) 784-2929

NPI assigned

Apr 25, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Melissa Ann Ehart, LPC, CAADC

Title

Clinical Supervisior

Phone

(517) 784-2929

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1461542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461542400000",
    "number": "1548615818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 LANSING AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492021621",
            "telephone_number": "517-784-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 LANSING AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492021621",
            "telephone_number": "517-784-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY CLINICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-25",
        "last_updated": "2016-04-25",
        "status": "A",
        "authorized_official_last_name": "EHART",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CLINICAL SUPERVISIOR",
        "authorized_official_telephone_number": "517-784-2929",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC, CAADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Jackson, MI by specialty
• Addiction (Substance Use Disorder) Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; 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.