Alyssa P. Vitali, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

247039 Issued in KY

Practice address

460 Wilson Ave
Versailles, KY 40383-1947

Phone

(859) 753-6626

Fax

(859) 787-0552

NPI assigned

Sep 28, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Revitalize Counseling Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Versailles, KY
  • NPI 1013476639
  NPD Authorized official

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

{
    "created_epoch": "1443398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1154791630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 RYNE CT",
            "city": "VERSAILLES",
            "state": "KY",
            "postal_code": "403831390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 WILSON AVE",
            "city": "VERSAILLES",
            "state": "KY",
            "postal_code": "403831947",
            "telephone_number": "859-753-6626",
            "fax_number": "859-787-0552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "411 Ryne Ct",
            "address_purpose": "LOCATION",
            "city": "Versailles",
            "state": "KY",
            "postal_code": "403831390",
            "country_code": "US",
            "telephone_number": "859-753-6626",
            "fax_number": "859-787-0552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VITALI",
        "first_name": "ALYSSA",
        "middle_name": "P.",
        "name_prefix": "Miss",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-28",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "247039",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "KY",
            "license": "247039",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "247039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPCC",
            "identifier": "247039",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Versailles Family Medicine, PLLC
• Versailles Independent Pharmacy, Inc.
• Versailles Internal Medicine, PLC
• Douglas E Vick, DO
• Mary Tamarin Vick, DO
• Gary John Vitali, ED.D., NBC
• Steve T Vogelsang, MD
• Rhonda Wade
• Forest Platt Walker, M.D.
• Harry M Watts, DMD

• Professional Counselor in Versailles, KY
• Providers in Versailles, KY by specialty
• Professional Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.