Provider Demographics
NPI:1790018794
Name:VICTORY COUNSELING CENTER, INC.
Entity Type:Organization
Organization Name:VICTORY COUNSELING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:915-591-4054
Mailing Address - Street 1:1600 N LEE TREVINO DR
Mailing Address - Street 2:SUITE C-4
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-5169
Mailing Address - Country:US
Mailing Address - Phone:915-591-4054
Mailing Address - Fax:915-590-7222
Practice Address - Street 1:1600 N LEE TREVINO DR
Practice Address - Street 2:SUITE C-4
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-5169
Practice Address - Country:US
Practice Address - Phone:915-591-4054
Practice Address - Fax:915-590-7222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-09
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12928101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty