NPIMap

Organization Active NPI

Vivify Counseling and Coaching PLLC

  • Professional Counselor
  • Pantego, TX
National Provider Identifier
1295489334
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
VIVIFY COUNSELING AND COACHING PLLC
Practice address
3613 W Pioneer Pkwy Ste a
Pantego, TX 76013-4517
Phone
(972) 754-0788
NPI assigned
Feb 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Authorized official

Name
Grant BoatwrightNPI 1417725268
Title
Cofounder
Phone
(972) 754-0788

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
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

3613 W Pioneer Pkwy Ste a
Pantego, TX 76013-4517

Mailing address

4900 Bradley LN
Arlington, TX 76017-3051
Phone (972) 754-0788

National Provider Directory

National Provider Directory

Locations

3613 W Pioneer Pkwy
Ste A
Pantego, TX 76013
Phone (817) 646-6823

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1295489334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 BRADLEY LN",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760173051",
            "telephone_number": "972-754-0788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3613 W PIONEER PKWY STE A",
            "city": "PANTEGO",
            "state": "TX",
            "postal_code": "760134517",
            "telephone_number": "972-754-0788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVIFY COUNSELING AND COACHING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-08",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "BOATWRIGHT",
        "authorized_official_first_name": "GRANT",
        "authorized_official_title_or_position": "COFOUNDER",
        "authorized_official_telephone_number": "972-754-0788"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pantego, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.