Individual provider Active NPI

Vanessa Kiyoko Lane McNally, M.S.

  • Mental Health Counselor
  • Panama City, FL
National Provider Identifier
1083284939
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH18966 Issued in FL
Practice address
2615 W 23Rd St
Panama City, FL 32405-2339
Phone
(850) 331-0134
NPI assigned
Jul 1, 2021
Last updated
Jul 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMH18966 FL Primary

Addresses

Primary practice location

2615 W 23Rd St
Panama City, FL 32405-2339

Mailing address

2615 W 23Rd St
Panama City, FL 32405-2339
Phone (850) 331-0134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
IMH18966FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Legacy House PLLC CurrentSince Jul 4, 2021 Accepting new patients

Locations

2615 W 23rd St
Panama City, FL 32405
Phone (850) 331-0134

725 E 24th Plz
Panama City, FL 32405
Phone (850) 331-0134

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1083284939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 W 23RD ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324052339",
            "telephone_number": "850-331-0134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 W 23RD ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324052339",
            "telephone_number": "850-331-0134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNALLY",
        "first_name": "VANESSA",
        "middle_name": "KIYOKO LANE",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH18966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; 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.