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Organization

Victa LLC

NPI Record: ActiveInternal Medicine — Addiction Medicine
NPI1104317007
Providence, Rhode Island

Provider's NPPES record last updated: June 8, 2026

Overview

Entity Type
Organization
NPI
1104317007
Primary Specialty
Internal Medicine — Addiction Medicine
Practice Location
Providence, Rhode Island
Organization Subpart
No

Federal Screening

NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.

List of Excluded Individuals/Entities (LEIE)

HHS Office of Inspector General

No potential match identified

No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.

Source data
September 10, 2026
Records indexed
84,001
Screened
Sep 18, 2026, 11:53 AM UTC

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

SAM.gov Exclusions

U.S. General Services Administration

Not checked

SAM.gov Exclusions was not checked.

SAM.gov screening is not configured on this deployment. No SAM check has been performed.

Screened
Not checked

This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

Run a name-based screening

Searches OIG LEIE and SAM.gov by name and reviews every potential match.

Specialties & Taxonomies

  • Internal Medicine

    Addiction Medicine

    Allopathic & Osteopathic Physicians

    Primary

    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.

    Taxonomy code 207RA0401X
  • Counselor

    Behavioral Health & Social Service Providers

    A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

    Taxonomy code 101Y00000X
  • Counselor

    Addiction (Substance Use Disorder)

    Behavioral Health & Social Service Providers

    Definition to come...

    Taxonomy code 101YA0400X
  • Counselor

    Mental Health

    Behavioral Health & Social Service Providers

    Definition to come...

    Taxonomy code 101YM0800X
  • Psychologist

    Addiction (Substance Use Disorder)

    Behavioral Health & Social Service Providers

    A psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior.

    Taxonomy code 103TA0400X
  • Psychologist

    Counseling

    Behavioral Health & Social Service Providers

    A psychologist who specializes in general practice and health service. It focuses on how people function both personally and in their relationships at all ages. Counseling psychology addresses the emotional, social, work, school and physical health concerns people may have at different stages in their lives, focusing on typical life stresses and more severe issues with which people may struggle as individuals and as a part of families, groups and organizations. Counseling psychologists help people with physical, emotional and mental health issues improve their sense of well-being, alleviate feelings of distress and resolve crises. They also provide assessment, diagnosis, and treatment of more severe psychological symptoms.

    Taxonomy code 103TC1900X
  • Marriage & Family Therapist

    Behavioral Health & Social Service Providers

    A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

    Taxonomy code 106H00000X
  • Registered Nurse

    Addiction (Substance Use Disorder)

    Nursing Service Providers

    Definition to come...

    Taxonomy code 163WA0400X
  • Registered Nurse

    Ambulatory Care

    Nursing Service Providers

    Definition to come...

    Taxonomy code 163WP2201X
  • Community Health Worker

    Other Service Providers

    Community health workers (CHW) are lay members of communities who work either for pay or as volunteers in association with the local health care system in both urban and rural environments and usually share ethnicity, language, socioeconomic status and life experiences with the community members they serve. They have been identified by many titles such as community health advisors, lay health advocates, "promotores(as), outreach educators, community health representatives, peer health promoters, and peer health educators. CHWs offer interpretation and translation services, provide culturally appropriate health education and information, assist people in receiving the care they need, give informal counseling and guidance on health behaviors, advocate for individual and community health needs, and provide some direct services such as first aid and blood pressure screening. Some examples of these practitioners are Community Health Aides or Practitioners established under 25 USC 1616 (l) under HHS, Indian Health Service, Public Health Service.

    Taxonomy code 172V00000X
  • Peer Specialist

    Other Service Providers

    Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

    Taxonomy code 175T00000X
  • Internal Medicine

    Infectious Disease

    Allopathic & Osteopathic Physicians

    An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.

    Taxonomy code 207RI0200X
  • Clinic/Center

    Mental Health (Including Community Mental Health Center)

    Ambulatory Health Care Facilities

    Definition to come...

    Taxonomy code 261QM0801X
  • Clinic/Center

    Rehabilitation, Substance Use Disorder

    Ambulatory Health Care Facilities

    Definition to come...

    Taxonomy code 261QR0405X

Provider-Reported License Information

Clinic/Center (Rhode Island)
648.01
Clinic/Center (Rhode Island)
648.01
License numbers are reported by the provider to NPPES and are not independently verified by NPISignal against any state licensing board. Confirm current license status directly with the issuing state board.

Practice Locations

Practice Location

110 Elmwood Ave # A

Providence, Rhode Island 02907

Phone: (401) 868-0654

Record Information

Enumeration Date
May 25, 2018
Provider's NPPES Record Last Updated
June 8, 2026
Certification Date
June 8, 2026
NPISignal NPPES Dataset
August 2026

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