Visionary Vanguard Group

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH6575 Issued in FL

Legal business name

VISIONARY VANGUARD GROUP

Practice address

1200 Oakley Seaver Dr
Suite 203
Clermont, FL 34711-1958

Phone

(407) 314-5373

Fax

(888) 587-1421

NPI assigned

Aug 13, 2012

Last updated

Aug 13, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Stephan E. Brown, PHD, LMHC, NCC, BCABNPI 1700988292

Title

President & Ceo

Phone

(407) 497-0327

Specialties & licenses 5

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephan Brown, PHD, LMHC, NCC,

  • Mental Health Counselor
  • Clermont, FL
  • NPI 1700988292
  NPD Authorized official

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344816000000",
    "number": "1780931469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "976 LAKE BALDWIN LN",
            "address_2": "SUITE 203",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328146687",
            "telephone_number": "407-497-0327",
            "fax_number": "888-587-1421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 OAKLEY SEAVER DR",
            "address_2": "SUITE 203",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111958",
            "telephone_number": "407-314-5373",
            "fax_number": "888-587-1421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISIONARY VANGUARD GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-13",
        "last_updated": "2012-08-13",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "STEPHAN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "407-497-0327",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LMHC, NCC, BCAB"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH6575",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH6078",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "NCC #54428",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "NCC #48936",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "0000077",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Clermont, FL
• Providers in Clermont, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; 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.