Individual provider Active NPI

Brenda Ann Vitarius, CASAC-T

  • Addiction (Substance Use Disorder) Counselor
  • Kingston, NY
National Provider Identifier
1457147456
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
39083 Issued in NY
Practice address
150 Sawkill Rd
Kingston, NY 12401-1208
Phone
(845) 481-4728
NPI assigned
Apr 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 39083 NY Primary

Addresses

Primary practice location

150 Sawkill Rd
Kingston, NY 12401-1208

Mailing address

150 Sawkill Rd
Kingston, NY 12401-1208
Phone (845) 481-4728

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

LicenseStateTypeSpecialty
39083NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1744761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1457147456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 SAWKILL RD",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124011208",
            "telephone_number": "845-481-4728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 SAWKILL RD",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124011208",
            "telephone_number": "845-481-4728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITARIUS",
        "first_name": "BRENDA",
        "middle_name": "ANN",
        "credential": "CASAC-T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-16",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "39083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; 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.