Evan Vincent Vida, PSYD

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

PS020328 Issued in PA

Practice address

1518 Walnut St Ste 1702
Philadelphia, PA 19102-3409

Phone

(856) 249-0757

NPI assigned

Sep 12, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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.

• Center for Anxiety & Behavior Therapy

  • Clinical Psychologist
  • Bryn Mawr, PA
  • NPI 1154184109
  NPD (past)

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1174245732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 LOCUST ST APT 3708",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024325",
            "telephone_number": "203-803-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1518 WALNUT ST STE 1702",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191023409",
            "telephone_number": "856-249-0757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDA",
        "first_name": "EVAN",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-12",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "PA",
            "license": "PS020328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lidiaybeth C Victorianoabreu, LCSW
• Victory Care Healthcare Services LLC
• Victory Medical of Pennsylvania PC
• Victory Vision Inc
• Vida Quard Transportation Inc
• Vidal Home Care Services, LLC
• Alba Vidal Ronchas, MD
• Arianny Vidal, MA
• Daniel Vidal, LMT, CNS
• Joyce Videlock

• Cognitive & Behavioral Psychologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Cognitive & Behavioral Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; 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.