NPIMap

Organization Active NPI

Vitality Psychological Services LLC

  • Behavior Analyst
  • Phoenix, AZ
National Provider Identifier
1265904288
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
VITALITY PSYCHOLOGICAL SERVICES LLC
Practice address
3201 W Peoria Ave Ste A200
Phoenix, AZ 85029-4699
Phone
(602) 525-2018
NPI assigned
Jan 2, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Authorized official

Name
Christine Breuer, PHDNPI 1558880682
Title
Psychologist
Phone
(832) 427-7452

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

3201 W Peoria Ave Ste A200
Phoenix, AZ 85029-4699

Mailing address

3201 W Peoria Ave Ste A200
Phoenix, AZ 85029-4699
Phone (602) 525-2018

Other practice location 1

2222 W Pinnacle Peak Rd Ste 360
Phoenix, AZ 85027-1230
Phone (602) 525-2018

Other practice location 2

3201 W Peoria Ave Ste 408
Phoenix, AZ 85029-4608
Phone (602) 525-2018

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250611003685 AZ Part B Supplier - Clinic/Group Practice 0345762761 Receives reassigned benefits from 4 practitioners
Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory

Locations

2222 W Pinnacle Peak Rd
Ste 360
Phoenix, AZ 85027
Phone (602) 525-2018

3201 W Peoria Ave
Ste 408
Phoenix, AZ 85029
Phone (602) 525-2018

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1546387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758067200000",
    "number": "1265904288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 W PEORIA AVE STE A200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850294699",
            "telephone_number": "602-525-2018",
            "fax_number": "602-926-2238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 W PEORIA AVE STE A200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850294699",
            "telephone_number": "602-525-2018"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 W Pinnacle Peak Rd Ste 360",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850271230",
            "country_code": "US",
            "telephone_number": "602-525-2018",
            "fax_number": "602-926-2238",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3201 W Peoria Ave Ste 408",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850294608",
            "country_code": "US",
            "telephone_number": "602-525-2018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VITALITY PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-02",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A",
        "authorized_official_last_name": "BREUER",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "832-427-7452",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; 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.