Vita Linea, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

VITA LINEA, LLC

Practice address

333 NE 2ND St
Delray Beach, FL 33483-4522

Phone

(678) 207-9575

NPI assigned

May 13, 2019

Last updated

Mar 29, 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

David Niknafs

Title

Owner

Phone

(800) 829-4933

Specialties & licenses 4

Addresses

Locations

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648512000000",
    "number": "1538725940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 NE 2ND ST",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334834522",
            "telephone_number": "678-207-9575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 NE 2ND ST",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334834522",
            "telephone_number": "678-207-9575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITA LINEA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-13",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A",
        "authorized_official_last_name": "NIKNAFS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "800-829-4933"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Delray Beach, FL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; 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.