| Victory Mountain Psychotherapy, Inc | |
|
27659 Burgundy Crossing Lane Canyon Country CA 91351 | |
| (540) 842-4999 | |
| (540) 371-8428 |
| Full Name | Victory Mountain Psychotherapy, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 27659 Burgundy Crossing Lane, Canyon Country, California |
| Authorized Official Name and Position | Jeffrey Sumpolec (CEO/OWNER) |
| Authorized Official Contact | 5408424999 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Victory Mountain Psychotherapy, Inc 18565 Soledad Canyon Road Box 302 Canyon Country CA 91351-3700 Ph: (540) 842-4999 | Victory Mountain Psychotherapy, Inc 27659 Burgundy Crossing Lane Canyon Country CA 91351 Ph: (540) 842-4999 |
| NPI Number | 1942698246 |
|---|---|
| Provider Enumeration Date | 01/08/2015 |
| Last Update Date | 02/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942698246 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0701003590 (Virginia) | Primary |
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