Vine Life Counseling

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

VINE LIFE COUNSELING

Practice address

2310 S Grand Blvd
Saint Louis, MO 63104-1702

Phone

(314) 420-4733

NPI assigned

Feb 14, 2019

Last updated

Feb 14, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Alphonso Ivy Jr., LPC

Title

Owner Counselor

Phone

(314) 420-4733

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550102400000",
    "number": "1104382118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041702",
            "telephone_number": "314-420-4733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041702",
            "telephone_number": "314-420-4733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINE LIFE COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-14",
        "last_updated": "2019-02-14",
        "status": "A",
        "authorized_official_last_name": "IVY",
        "authorized_official_first_name": "ALPHONSO",
        "authorized_official_title_or_position": "OWNER COUNSELOR",
        "authorized_official_telephone_number": "314-420-4733",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vincent Sollecito,III
• Cyndra Vincent
• Joyce Diane Vincent
• Justin David Vincent, MD
• Nicole Frances Vinciguerra
• Vinedale Health Care, Inc. (Universal Medical Equipment)
• Melanie Ann Viner, DPT
• Linda Nicole Vines, MSW LCSW
• Ashley Vineyard, SLP
• Eric Vineyard, CRNA

• Community/Behavioral Health Agency in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Community/Behavioral Health Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; 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.