NPIMap

Organization Active NPI

Vista Psychological Services, PA

  • Mental Health Counselor
  • Winter Park, FL
National Provider Identifier
1013073980
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH1561 Issued in FL
Legal business name
VISTA PSYCHOLOGICAL SERVICES, PA
Practice address
120 University Park Dr
Suite 215
Winter Park, FL 32792-4440
Phone
(407) 657-5800
Fax
(407) 657-4269
NPI assigned
Dec 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Catherine W Gibson, MANPI 1508983255
Title
V Pres
Phone
(407) 657-5800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X MH1561 FL Primary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X MH3101 FL

Addresses

Primary practice location

120 University Park Dr
Suite 215
Winter Park, FL 32792-4440

Mailing address

PO Box 4728
Winter Park, FL 32793-4728
Phone (407) 657-5800

National Provider Directory

National Provider Directory

Locations

120 University Park Dr
Ste 215
Winter Park, FL 32792
Phone (407) 657-5800

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013073980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4728",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327934728",
            "telephone_number": "407-657-5800",
            "fax_number": "407-657-4269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 UNIVERSITY PARK DR",
            "address_2": "SUITE 215",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924440",
            "telephone_number": "407-657-5800",
            "fax_number": "407-657-4269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA PSYCHOLOGICAL SERVICES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "V PRES",
        "authorized_official_telephone_number": "407-657-5800",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH1561",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH3101",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.