NPIMap

Organization Active NPI

Vital Integrative Solutions LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1225719677
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
VITAL INTEGRATIVE SOLUTIONS LLC
Practice address
901 Custer Ave SE
Atlanta, GA 30316
Phone
(404) 939-2772
NPI assigned
Jul 28, 2023
Last updated
Jul 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Authorized official

Name
Dr. Tina Williams, DNP, CNM, FNP, PMHNPNPI 1871818526
Title
Ceo/Owner/Operator
Phone
(336) 253-8252

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 6

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Adult Mental Health Clinic/Center 261QM0850X NU
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU
Multi-Specialty Clinic/Center 261QM1300X NU
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary
Perinatal Nurse Practitioner 363LP1700X NU

Addresses

Primary practice location

901 Custer Ave SE
Atlanta, GA 30316

Mailing address

650 Ponce de Leon Ave NE Ste 300
Atlanta, GA 30308-1864
Phone (404) 939-2772

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1690502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690502400000",
    "number": "1225719677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 PONCE DE LEON AVE NE STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303081864",
            "telephone_number": "404-939-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 CUSTER AVE SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30316",
            "telephone_number": "404-939-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL INTEGRATIVE SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-28",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-17",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "CEO/OWNER/OPERATOR",
        "authorized_official_telephone_number": "336-253-8252",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, CNM, FNP, PMHNP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LP1700X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Perinatal",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; 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.