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VICTORY PSYCH CONSULTATION SERVICES
NPI 1124781364
Nurse Practitioner - Psychiatric/Mental Health in Blackwood, NJ

Active since October 14, 2021
188 FRIES MILL RD STE E2, BLACKWOOD, NJ 08012(551) 214-4475(609) 237-0772 Get Directions Write a Review

NPPES record last updated: July 22, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 22, 2026, Jul 25, 2024, Oct 22, 2021 and 1 more (4 updates tracked since 2021).

About Victory Psych Consultation Services NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VICTORY PSYCH CONSULTATION SERVICES (NPI 1124781364) is a healthcare organization registered as a psychiatric/mental health in Blackwood, New Jersey and active in the NPI registry since October 2021. The organization lists Yahaya A Animashaun, Nurse Practioner, as its authorized official.

NPPES Registry Identity

NPI1124781364
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameVICTORY PSYCH CONSULTATION SERVICES
Location Address188 FRIES MILL RD STE E2Blackwood, NJ 08012-2015
Mailing Address188 Fries Mill Rd Ste E2Blackwood, NJ 08012-2015 · (551) 214-4475 · Fax (609) 237-0772
Phone(551) 214-4475
Fax(609) 237-0772
Organization SubpartNo
Authorized OfficialYahaya A AnimashaunNurse Practioner · (908) 247-8768
Enumeration DateOctober 14, 2021
Last NPPES UpdateJuly 22, 20264 updates tracked since enumeration
NPPES CertifiedJuly 22, 2026
✔ NPI 1124781364 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
188 FRIES MILL RD STE E2, Blackwood, NJ 08012
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Victory Psych Consultation Services is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Victory Psych Consultation Services, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (6)

Yahaya Animashaun, PMHNP-BC
Nurse Practitioner
NPI 1710157961
188 FRIES MILL RD STE E2
Blackwood, NJ 08012
(551) 214-4475
✔ PECOS✔ Accepts MedicareSame address
Youma Kabia-Williams, LCSW
Clinical Social Worker
NPI 1629834999
188 FRIES MILL RD STE E2
Blackwood, NJ 08012
(551) 214-4475
✔ PECOS✔ Accepts MedicareSame address
Olufunke Attila, PMHNP
Nurse Practitioner
NPI 1467296533
188 FRIES MILL RD STE E2
Turnersville, NJ 08012
(551) 214-4475
✔ PECOS✔ Accepts Medicare0.1 mi
Alexis Goodwin, LCSW
Clinical Social Worker
NPI 1265321723
333 IRVING AVE
Bridgeton, NJ 08302
(856) 575-4288
✔ PECOS23 mi
Sheila Pierce-Williams, MSW, LCSW,CAMS II
Clinical Social Worker
NPI 1346980331
3017 SEAVIEW AVE
Millville, NJ 08332
(856) 265-6857
✔ PECOS✔ Accepts Medicare26 mi
Adedoyin Asimolowo
Nurse Practitioner
NPI 1821786146
647 STUYVESANT AVE
Irvington, NJ 07111
(908) 370-7546
✔ PECOS80 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Victory Psych Consultation Services's NPI number?

The NPI number for Victory Psych Consultation Services is 1124781364. It was assigned to this organization in the NPPES registry on October 14, 2021.

Where is Victory Psych Consultation Services located?

Victory Psych Consultation Services is located at 188 Fries Mill Rd Ste E2, Blackwood, NJ 08012. The listed phone number is (551) 214-4475.

What is Victory Psych Consultation Services's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Victory Psych Consultation Services enrolled in Medicare?

Yes. Victory Psych Consultation Services is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Victory Psych Consultation Services?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 2 Medicare specialties reassign their Medicare billing to Victory Psych Consultation Services. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Social Worker (3) and Nurse Practitioner (3). Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Victory Psych Consultation Services was last updated on July 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.