Amy Vitacolonna, MS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH60943631 Issued in WA

Practice address

117 Indian Warrior TRL
Lake Jackson, TX 77566-3253

Phone

(360) 349-8775

Fax

(843) 897-0100

NPI assigned

Mar 14, 2016

Last updated

Apr 8, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• Amy Mary Myrfield Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Agape Counseling and Healing Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Florence, SC
  • NPI 1255030862
  NPD Authorized official

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

{
    "created_epoch": "1457913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1497116875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15",
            "city": "ANGLETON",
            "state": "TX",
            "postal_code": "775160015",
            "telephone_number": "360-349-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 INDIAN WARRIOR TRL",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775663253",
            "telephone_number": "360-349-8775",
            "fax_number": "843-897-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITACOLONNA",
        "first_name": "AMY",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-14",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60943631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH",
            "identifier": "LH60943631",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS",
            "identifier": "95893",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTH CAROLINA LICENSING BOARD FOR COUNSELORS",
            "identifier": "8246",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS",
            "identifier": "85-2743925",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "MYRFIELD",
            "middle_name": "MARY",
            "credential": "MS, LMHC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-0808)
• Wal-Mart Stores Texas, LP (Vision Center 30-0808)

• Mental Health Counselor in Lake Jackson, TX
• Providers in Lake Jackson, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.