Active NPI
Vilda Stone Brannen, M.S., L.P.C.
- Professional Counselor
- Marietta, GA
National Provider Identifier
1740373711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC004368
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| LPC004368 | GA | MD | Professional Counselor |
| 4971 | NC | MD | Clinical 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.