Active NPI
Vivian Nelson Melle, MC, LAC
- Professional Counselor
- Tempe, AZ
National Provider Identifier
1295576197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LAC-22821
- Practice address
- 1250 W Washington St Ste 215
Tempe, AZ 85288-1697 - Phone
- (602) 842-7042
- NPI assigned
- Jun 4, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LAC-22821 | AZ | Primary |
Addresses
Primary practice location
1250 W Washington St Ste 215
Tempe, AZ 85288-1697
Mailing address
4648 E Palm LN
Phoenix, AZ 85008-4144
Phone (623) 451-4800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LAC-22821 | AZ | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mindful Therapy Group PC | Current | Accepting new patients |
Locations
1250 W Washington St
Ste 215
Tempe, AZ 85288
Phone (602) 842-7042
Organizations & group practices 1
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717459200000",
"number": "1295576197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4648 E PALM LN",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850084144",
"telephone_number": "623-451-4800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 W WASHINGTON ST STE 215",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852881697",
"telephone_number": "602-842-7042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON MELLE",
"first_name": "VIVIAN",
"name_prefix": "Mrs.",
"credential": "MC, LAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-04",
"last_updated": "2024-06-04",
"certification_date": "2024-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LAC-22821",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tempe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.