Vitality Counseling LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

VITALITY COUNSELING LLC

Practice address

3305 W Bancroft St
Ottawa Hills, OH 43606-2601

Phone

(419) 461-1983

NPI assigned

Oct 18, 2022

Organization subpart

No

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

Authorized official

Name

Elizabeth E Bergman, LPCCNPI 1659879849

Title

Owner

Phone

(419) 461-1983

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

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

• Elizabeth Bergman

  • Professional Counselor
  • Genoa, OH
  • NPI 1659879849
  NPD Authorized official

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666051200000",
    "number": "1083330393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 W BANCROFT ST",
            "city": "OTTAWA HILLS",
            "state": "OH",
            "postal_code": "436062601",
            "telephone_number": "419-461-1983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 W BANCROFT ST",
            "city": "OTTAWA HILLS",
            "state": "OH",
            "postal_code": "436062601",
            "telephone_number": "419-461-1983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A",
        "authorized_official_last_name": "BERGMAN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-461-1983",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659879849",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0266112",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jenna Bartley Stengle
• Team Jones Medical Associates LLC
• Autumn Wetli, SWT
• Keelie Rae Wimmers
• Angelina Wong, NP
• Liping Yu
• Erica Blake Zimmerman, OTR/L

• Mental Health Clinic/Center (Including Community Mental Health Center) in Ottawa Hills, OH
• Providers in Ottawa Hills, OH by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.