Provider Demographics
NPI:1558247197
Name:VICTORIAN, ASHLEY RENEE (CSW-I)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RENEE
Last Name:VICTORIAN
Suffix:
Gender:F
Credentials:CSW-I
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:RENEE
Other - Last Name:HAMILTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3728 PECOS PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-6625
Mailing Address - Country:US
Mailing Address - Phone:702-423-7191
Mailing Address - Fax:
Practice Address - Street 1:2400 N TENAYA WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0643
Practice Address - Country:US
Practice Address - Phone:725-222-0263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10951-M104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker