Vital Mental Health PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

VITAL MENTAL HEALTH PLLC

Practice address

1700 Highway 36 W Ste 330
Roseville, MN 55113-4034

Phone

(763) 357-0931

NPI assigned

Mar 6, 2024

Organization subpart

No

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

Authorized official

Name

Adam WickNPI 1952033680

Title

Owner

Phone

(763) 357-0931

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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.

• Adam Wick, MA, LPCC, LADC

  • Mental Health Counselor
  • Andover, MN
  • NPI 1952033680
  NPD Authorized official

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

{
    "created_epoch": "1709683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1649038514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 HIGHWAY 36 W STE 330",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 HIGHWAY 36 W STE 330",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134034",
            "telephone_number": "763-357-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL MENTAL HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-06",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "WICK",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-357-0931"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Marie Vievering, OTR
• Villas at Roseville LLC
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• Viverantos, LLC
• Kaylah Christine Vogt
• Alison Rene Wagenknecht, M.D.
• Kathleen Wagner
• Joel Walgenbach, CRNA

• Clinic/Center in Roseville, MN
• Providers in Roseville, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.