A Vibrant Mind Counseling, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

A VIBRANT MIND COUNSELING, LLC

Practice address

2900 Louisiana Blvd NE Ste 200D
Albuquerque, NM 87110-3589

Phone

(505) 397-4189

NPI assigned

Jan 31, 2022

Last updated

Jun 13, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicole Hartson, LPCCNPI 1548408545

Title

Owner/Director

Phone

(505) 397-4189

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicole M. Hartson, LPCC

  • Professional Counselor
  • Albuquerque, NM
  • NPI 1548408545
  Medicare reassignment NPD Authorized official
• Jane Meredith Wootton, PH.D.

  • Psychologist
  • Louisa, VA
  • NPI 1639393143
  NPD

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655078400000",
    "number": "1508519430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 LOUISIANA BLVD NE STE 200D",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871103589",
            "telephone_number": "505-397-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 LOUISIANA BLVD NE STE 200D",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871103589",
            "telephone_number": "505-397-4189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A VIBRANT MIND COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-31",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A",
        "authorized_official_last_name": "HARTSON",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "505-397-4189",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.