Vitality Well Mental Health Providers Inc

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

VITALITY WELL MENTAL HEALTH PROVIDERS INC

Practice address

3 Allied Dr Ste 311
Dedham, MA 02026-6148

Phone

(857) 437-8574

NPI assigned

Aug 9, 2024

Organization subpart

No

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

Authorized official

Name

Grace MbawuikeNPI 1679229447

Title

Owner

Phone

(857) 437-8574

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Practitioners 1

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

• Grace Mbawuike, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Boston, MA
  • NPI 1679229447
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1723161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723161600000",
    "number": "1497586788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 ALLIED DR STE 311",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020266148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 ALLIED DR STE 311",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020266148",
            "telephone_number": "857-437-8574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY WELL MENTAL HEALTH PROVIDERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A",
        "authorized_official_last_name": "MBAWUIKE",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "857-437-8574"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vibrant Dermatology PLLC
• Amandha Vielman
• April Danielle Violante, RD, LDN
• Visions Medical Center, PC
• Visology Inc
• Kristen E.T. Vito, PT, DPT
• Gina Marie Vizard
• Yelena Volnova
• Erica Vozzella
• Carson Wagor, PA-C

• Psychiatric/Mental Health Nurse Practitioner in Dedham, MA
• Providers in Dedham, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.