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Organization
VICTA LLC
Active
Organization
VICTA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEXANDER DONOYAN (CEO)
(401) 300-5757
Entity
Organization
Contact information
Practice address
110 ELMWOOD AVE # A, PROVIDENCE, RI 02907
(401) 868-0654
Mailing address
110 ELMWOOD AVE, PROVIDENCE, RI 02907-2423
(401) 300-5757
(401) 300-5656
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NULL
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
NULL
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TC1900X
Counseling Psychologist
—
NULL
103TC1900X
Counseling Psychologist
—
—
106H00000X
Marriage & Family Therapist
—
NULL
106H00000X
Marriage & Family Therapist
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
—
NULL
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
—
—
163WP2201X
Ambulatory Care Registered Nurse
—
NULL
163WP2201X
Ambulatory Care Registered Nurse
—
—
172V00000X
Community Health Worker
—
NULL
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
—
NULL
175T00000X
Peer Specialist
—
—
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
NULL
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
—
207RI0200X
Infectious Disease Physician
—
NULL
207RI0200X
Infectious Disease Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
648.01
RI
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
648.01
RI
Other
Enumeration date
05/25/2018
Last updated
06/08/2026
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