NPIMap

Organization Active NPI

Vibrant Mental Wellness LLC

  • Psychiatric/Mental Health Registered Nurse
  • Fort Worth, TX
National Provider Identifier
1861257776
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
Legal business name
VIBRANT MENTAL WELLNESS LLC
Practice address
702 Houston St
Fort Worth, TX 76102-5004
Phone
(763) 568-6378
NPI assigned
Feb 20, 2024
Last updated
Feb 20, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
VIBRANT MENTAL WELLNESS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Authorized official

Name
Jackline AukaNPI 1417675026
Title
Owner
Phone
(432) 267-8216

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X NU Primary

Addresses

Primary practice location

702 Houston St
Fort Worth, TX 76102-5004

Mailing address

702 Houston St
Fort Worth, TX 76102-5004

National Provider Directory

National Provider Directory
Tax ID family
Vibrant Mental Wellness LLC3 organizations share this tax ID, including this one
Part of
Vibrant Mental Wellness LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

702 Houston St
Fort Worth, TX 76102
Phone (817) 813-8655

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1708387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708387200000",
    "number": "1861257776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 HOUSTON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761025004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 HOUSTON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761025004",
            "telephone_number": "763-568-6378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIBRANT MENTAL WELLNESS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VIBRANT MENTAL WELLNESS LLC",
        "enumeration_date": "2024-02-20",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A",
        "authorized_official_last_name": "AUKA",
        "authorized_official_first_name": "JACKLINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "432-267-8216"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.