NPIMap

Organization Active NPI

Vibrant Women Wellness Counseling, LCSW, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fresh Meadows, NY
National Provider Identifier
1609428770
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
VIBRANT WOMEN WELLNESS COUNSELING, LCSW, PLLC
Practice address
7580 184TH St
Fresh Meadows, NY 11366-1715
Phone
(718) 844-5390
Fax
(718) 732-2656
NPI assigned
Jul 9, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Authorized official

Name
Dr. Fazeeda Abdur-Rahman, PH.D,. LCSWNPI 1063608339
Title
Owner
Phone
(718) 844-5390

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

7580 184TH St
Fresh Meadows, NY 11366-1715

Mailing address

7580 184TH St
Fresh Meadows, NY 11366-1715
Phone (718) 844-5390

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1562630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694390400000",
    "number": "1609428770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7580 184TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661715",
            "telephone_number": "718-844-5390",
            "fax_number": "718-732-2656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7580 184TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661715",
            "telephone_number": "718-844-5390",
            "fax_number": "718-732-2656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIBRANT WOMEN WELLNESS COUNSELING, LCSW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-09",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A",
        "authorized_official_last_name": "ABDUR-RAHMAN",
        "authorized_official_first_name": "FAZEEDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-844-5390",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D,. LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.