Active NPI
Stephanie Leslie Vitolo, MS, LMHC
- Mental Health Counselor
- Indiana, PA
National Provider Identifier
1609415017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 16761
- Practice address
- 163 Plaza Rd
Indiana, PA 15701-3264 - Phone
- (724) 465-2311
- NPI assigned
- Jan 2, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 16761 | FL | Primary |
Addresses
Primary practice location
163 Plaza Rd
Indiana, PA 15701-3264
Mailing address
585 N 6TH St
Indiana, PA 15701-1203
Phone (561) 310-6745
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16761 | FL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Psychological Services | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Psychologist
- Indiana, PA
- NPI 1598136665
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1577923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577923200000",
"number": "1609415017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "585 N 6TH ST",
"city": "INDIANA",
"state": "PA",
"postal_code": "157011203",
"telephone_number": "561-310-6745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "163 PLAZA RD",
"city": "INDIANA",
"state": "PA",
"postal_code": "157013264",
"telephone_number": "724-465-2311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VITOLO",
"first_name": "STEPHANIE",
"middle_name": "LESLIE",
"name_prefix": "Mrs.",
"credential": "MS, LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-02",
"last_updated": "2020-01-02",
"certification_date": "2020-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "16761",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indiana, PA
- Deanna Catherine Villanueva, FNP-C
- Visiting Nurse Assoc. of Indiana County
- Visiting Nurse Association of Indiana County
- Visiting Nurse Association of Indiana County
- William A Vitalie, DMD
- Vna Extended Home Care
- Vna Extended Home Care, Inc.
- Yliesa Wade
- Christopher Michael Wagner, B.S.
- Wal-Mart Stores East LP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.