Individual provider Active NPI

Vivette Lanzas, MS, LMHC, LCMHC

  • Mental Health Counselor
  • Greensboro, NC
National Provider Identifier
1093141269
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
16583 Issued in NC
Practice address
603 Dolley Madison Rd Ste 100
Greensboro, NC 27410-4282
Phone
(336) 632-3505
NPI assigned
Sep 19, 2013
Last updated
Jun 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH15853 FL
Mental Health Counselor 101YM0800X MH 9234 FL
Mental Health Counselor 101YM0800X 16583 NC Primary
Professional Counselor 101YP2500X 10920 NC
Behavior Analyst 103K00000X FL

Addresses

Primary practice location

603 Dolley Madison Rd Ste 100
Greensboro, NC 27410-4282

Mailing address

603 Dolley Madison Rd Ste 100
Greensboro, NC 27410-4282
Phone (336) 632-3505

Other identifiers 1

IdentifierTypeStateIssuer
1295050292OtherFLNPI FOR BUSINESS ELITE PSYCHOTHERAPY, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240111002496 NC Practitioner - Mental Health Counselor 4981055100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Triad Psychiatric and Counseling Center PAGroup PAC ID 3173590882, 23 clinicians

Practice addresses (Care Compare)

603 Dolley Madison Rd
Suite 100
Greensboro, NC 27410-4282
Phone (336) 632-3505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
MH 9234FLMDMental Health Counselor
MH15853FLMDMental Health Counselor
16583NCMDMental Health Counselor
10920NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Triad Psychiatric and Counseling Center PA Single Specialty CurrentSince Jan 1, 2024 Accepting new patients

Locations

603 Dolley Madison Rd
Ste 100
Greensboro, NC 27410
Phone (336) 632-3505

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": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1093141269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 DOLLEY MADISON RD STE 100",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274104282",
            "telephone_number": "336-632-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 DOLLEY MADISON RD STE 100",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274104282",
            "telephone_number": "336-632-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANZAS",
        "first_name": "VIVETTE",
        "name_prefix": "Mrs.",
        "credential": "MS, LMHC, LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-19",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH15853",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 9234",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "16583",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "10920",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FOR BUSINESS ELITE PSYCHOTHERAPY, LLC",
            "identifier": "1295050292",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.