Individual provider Active NPI

Victoria Doree Coleman, ED.D.

  • Mental Health Counselor
  • Las Vegas, NV
National Provider Identifier
1932315447
Registry record updated Nov 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CP0164 Issued in NV
Practice address
9811 W Charleston Blvd
Suite 2-376
Las Vegas, NV 89117-7528
Phone
(702) 220-5300
Fax
(708) 405-4105
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2025

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

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180.008854 IL
Mental Health Counselor 101YM0800X CP0164 NV Primary
Professional Counselor 101YP2500X CP0164 NV
Nutrition Education Nutritionist 133NN1002X
Research Study Specialist 1744R1102X
Marriage & Family Therapist 106H00000X 35000688A IN
Addiction (Substance Use Disorder) Counselor 101YA0400X 17914
Homeopath 175L00000X
Clinical Social Worker 1041C0700X 34002388A IN
Counseling Psychologist 103TC1900X
Professional Counselor 101YP2500X 976 CA
Naturopath 175F00000X
Professional Counselor 101YP2500X 6401000417 MI

Addresses

Primary practice location

9811 W Charleston Blvd
Suite 2-376
Las Vegas, NV 89117-7528

Mailing address

9811 W Charleston Blvd
Suite 2-376
Las Vegas, NV 89117-7528
Phone (702) 220-5300

Other names 1

  • Dr. Vicki Doree Coleman Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251212000280 NV Practitioner - Mental Health Counselor 6305263252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1972
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6505 216TH St SW
Suite 100
Mountlake Terrace, WA 98043-2089

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP0164NVMDMental Health Counselor
180.008854ILMDProfessional Counselor
6401000417MIMDProfessional Counselor
34002388AINMDClinical Social Worker
35000688AINMDMarriage & Family Therapist
976CAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Therapy Group PC Mental Health CurrentSince Nov 4, 2025 Accepting new patients
Serenity One Behavioral Health Care, LLC. Past Accepting new patients

Locations

8215 S Eastern Ave
Ste 109
Las Vegas, NV 89123
Phone (775) 902-8300

4670 S Fort Apache Rd
Ste 180
Las Vegas, NV 89147
Phone (402) 830-4255

6505 216th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 678-6463

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764201600000",
    "number": "1932315447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9811 W CHARLESTON BLVD",
            "address_2": "SUITE 2-376",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891177528",
            "telephone_number": "702-220-5300",
            "fax_number": "708-405-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9811 W CHARLESTON BLVD",
            "address_2": "SUITE 2-376",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891177528",
            "telephone_number": "702-220-5300",
            "fax_number": "708-405-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "VICTORIA",
        "middle_name": "DOREE",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2025-11-27",
        "certification_date": "2025-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.008854",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NV",
            "license": "CP0164",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NV",
            "license": "CP0164",
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1744R1102X",
            "taxonomy_group": "",
            "desc": "Specialist, Research Study",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35000688A",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": "17914",
            "primary": false
        },
        {
            "code": "175L00000X",
            "taxonomy_group": "",
            "desc": "Homeopath",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34002388A",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "976",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401000417",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICKI",
            "last_name": "COLEMAN",
            "middle_name": "DOREE",
            "prefix": "DR.",
            "credential": "ED.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.