Organization · Type 2 NPI
Victa LLC
Addiction Medicine (Internal Medicine) Physician · Providence, RI
Practice location
110 Elmwood Ave # A
Providence, RI 02907
Mailing address
110 Elmwood Ave
Providence, RI 02907-2423
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor | 101Y00000X | None listed |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | None listed |
| Mental Health Counselor | 101YM0800X | None listed |
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | None listed |
| Counseling Psychologist | 103TC1900X | None listed |
| Marriage & Family Therapist | 106H00000X | None listed |
| Addiction (Substance Use Disorder) Registered Nurse | 163WA0400X | None listed |
| Ambulatory Care Registered Nurse | 163WP2201X | None listed |
| Community Health Worker | 172V00000X | None listed |
| Peer Specialist | 175T00000X | None listed |
| Addiction Medicine (Internal Medicine) Physician Primary | 207RA0401X | None listed |
| Infectious Disease Physician | 207RI0200X | None listed |
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | 648.01 (RI) |
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | 648.01 (RI) |
Addiction Medicine (Internal Medicine) Physician: An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.
Other addiction medicine (internal medicine) physician providers in Providence
About NPI 1104317007
Victa LLC's National Provider Identifier is 1104317007, issued on May 25, 2018. The primary taxonomy on file is Addiction Medicine (Internal Medicine) Physician (207RA0401X), and the practice location is in Providence, RI. The record was last updated on Jun 8, 2026.