Individual provider Active NPI

Vilda Stone Brannen, M.S., L.P.C.

  • Professional Counselor
  • Marietta, GA
National Provider Identifier
1740373711
Registry record updated Apr 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC004368 Issued in GA
Practice address
1640 Powers Ferry Rd SE, 16-100
Marietta, GA 30067-5491
Phone
(404) 310-6120
Fax
(770) 952-2878
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC004368 GA Primary
Professional Counselor 101YP2500X 4971 NC

Addresses

Primary practice location

1640 Powers Ferry Rd SE, 16-100
Marietta, GA 30067-5491

Mailing address

1640 Powers Ferry Rd SE, 16-100
Marietta, GA 30067-5491
Phone (404) 310-6120

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

LicenseStateTypeSpecialty
LPC004368GAMDProfessional Counselor
4971NCMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1740373711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 POWERS FERRY RD SE, 16-100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300675491",
            "telephone_number": "404-310-6120",
            "fax_number": "770-952-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 POWERS FERRY RD SE, 16-100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300675491",
            "telephone_number": "404-310-6120",
            "fax_number": "770-952-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANNEN",
        "first_name": "VILDA",
        "middle_name": "STONE",
        "credential": "M.S., L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC004368",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "4971",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; 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.