Vividly Profound LLC

Primary specialty

Phlebotomy TechnicianTaxonomy code 246RP1900X

Legal business name

VIVIDLY PROFOUND LLC

Practice address

8210 Macedonia Commons Blvd
Ste 3B #2172
Macedonia, OH 44056

Phone

(440) 561-0986

NPI assigned

Apr 1, 2026

Organization subpart

No

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

Authorized official

Name

Destiny Harriston, MA

Title

Medical Assistant/Phlebotomist

Phone

(440) 561-0986

Specialties & licenses 1

Addresses

Other names 1

• Vitalized Laboratory Doing business as

Locations

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

{
    "created_epoch": "1775001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775001600000",
    "number": "1184565665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8210 MACEDONIA COMMONS BLVD",
            "address_2": "STE 3B #2172",
            "city": "MACEDONIA",
            "state": "OH",
            "postal_code": "44056",
            "telephone_number": "440-561-0986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8210 MACEDONIA COMMONS BLVD",
            "address_2": "STE 3B #2172",
            "city": "MACEDONIA",
            "state": "OH",
            "postal_code": "44056",
            "telephone_number": "440-561-0986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVIDLY PROFOUND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-01",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A",
        "authorized_official_last_name": "HARRISTON",
        "authorized_official_first_name": "DESTINY",
        "authorized_official_title_or_position": "MEDICAL ASSISTANT/PHLEBOTOMIST",
        "authorized_official_telephone_number": "440-561-0986",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vitalized Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Manish Valiathan, MDS DDS MSD
• Dharmishta Vallabh, B.S.P.S, PHARMD
• Dawn Elaine Vana
• Indiradevi Vellanki, MD
• Ida G Vickers, LPN
• Melissa Voigt, BSN, RN, IBCLC
• Jessica Ann Von Benken, NP
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walgreen Co

• Phlebotomy Technician in Macedonia, OH
• Providers in Macedonia, OH by specialty
• Phlebotomy Technician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2026; 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.