Vitamind Counseling PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

VITAMIND COUNSELING PLLC

Practice address

149 Gene Hill Rd
Mount Airy, NC 27030-9072

Phone

(336) 553-8147

NPI assigned

Jan 31, 2023

Organization subpart

No

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

Authorized official

Name

Jacob Long, LCMHC, LPC, LCASANPI 1083335285

Title

Owner

Phone

(336) 553-8147

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, VA2 enrollments

Enrollment records 2

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacob Long, MA

  • Mental Health Counselor
  • Mount Airy, NC
  • NPI 1083335285

  VA

  Medicare reassignment NPD Authorized official
• Elizabeth Del Hollingsworth, LPC

  • Professional Counselor
  • Radford, VA
  • NPI 1083485049
  Medicare reassignment NPD (past)

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

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675123200000",
    "number": "1831895994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 GENE HILL RD",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270309072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 GENE HILL RD",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270309072",
            "telephone_number": "336-553-8147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAMIND COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-553-8147",
        "authorized_official_credential": "LCMHC, LPC, LCASA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Mount Airy, NC
• Providers in Mount Airy, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.