Active NPI
Vickie B. Bundy, LMHC
- Professional Counselor
- Sarasota, FL
National Provider Identifier
1780724997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0701003913
- Practice address
- 1616 Redwood St Apt 4
Sarasota, FL 34231-3836 - Phone
- (276) 794-1043
- NPI assigned
- Feb 7, 2007
- Last updated
- May 10, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701003913 | VA | Primary |
Addresses
Primary practice location
1616 Redwood St Apt 4
Sarasota, FL 34231-3836
Mailing address
1616 Redwood St Apt 4
Sarasota, FL 34231-3836
Phone (276) 794-1043
Other practice location 1
4422 E. Columbus Dr.
Tampa, FL 33605
Phone (813) 384-4033
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701003913 | VA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589068800000",
"number": "1780724997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1616 REDWOOD ST APT 4",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342313836",
"telephone_number": "276-794-1043",
"fax_number": "813-612-9373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1616 REDWOOD ST APT 4",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342313836",
"telephone_number": "276-794-1043"
}
],
"practiceLocations": [
{
"address_1": "4422 E. Columbus Dr.",
"address_purpose": "LOCATION",
"city": "Tampa",
"state": "FL",
"postal_code": "33605",
"country_code": "US",
"telephone_number": "813-384-4033",
"fax_number": "813-612-9373",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BUNDY",
"first_name": "VICKIE",
"middle_name": "B.",
"name_prefix": "Mrs.",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-07",
"last_updated": "2020-05-10",
"certification_date": "2020-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701003913",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sarasota, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.