Individual provider Active NPI

Vickie B. Bundy, LMHC

  • Professional Counselor
  • Sarasota, FL
National Provider Identifier
1780724997
Registry record updated May 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701003913 Issued in VA
Practice address
1616 Redwood St Apt 4
Sarasota, FL 34231-3836
Phone
(276) 794-1043
NPI assigned
Feb 7, 2007
Last updated
May 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
0701003913VAMDProfessional 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.

Verify at the official NPI Registry.