NPIMap

Organization Active NPI

Poverello House

  • Professional Counselor
  • Fresno, CA
National Provider Identifier
1144809161
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
POVERELLO HOUSE
Practice address
412 F St
Fresno, CA 93706-3409
Phone
(559) 498-6988
NPI assigned
Apr 6, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Authorized official

Name
Mr. Xainyavong Vang, LPCC 16877NPI 1699397596
Title
Director of Mental Health Services
Phone
(559) 498-6988

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary
Developmentally Disabled Services Day Training Agency 251C00000X
Supports Brokerage Agency 251X00000X

Addresses

Primary practice location

412 F St
Fresno, CA 93706-3409

Mailing address

412 F St
Fresno, CA 93706-3409
Phone (559) 498-6988

Other practice location 1

412 F St
Fresno, CA 93706-3409
Phone (559) 498-6988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260331003535 CA Part B Supplier - Clinic/Group Practice 0941640742 Receives reassigned benefits from 1 practitioner
Practice locations: Fresno, CA

National Provider Directory

National Provider Directory

Locations

412 F St
Fresno, CA 93706
Phone (559) 498-6988

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775779200000",
    "number": "1144809161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 F ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937063409",
            "telephone_number": "559-498-6988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 F ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937063409",
            "telephone_number": "559-498-6988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "412 F St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937063409",
            "country_code": "US",
            "telephone_number": "559-498-6988",
            "fax_number": "559-485-6548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "POVERELLO HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-06",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A",
        "authorized_official_last_name": "VANG",
        "authorized_official_first_name": "XAINYAVONG",
        "authorized_official_title_or_position": "DIRECTOR OF MENTAL HEALTH SERVICES",
        "authorized_official_telephone_number": "559-498-6988",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPCC 16877"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.