Vitality Psychological Services, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

486 Issued in SD

Legal business name

VITALITY PSYCHOLOGICAL SERVICES, LLC

Practice address

4900 S Minnesota Ave Ste 103
Sioux Falls, SD 57108-2813

Phone

(605) 370-5665

Fax

(866) 277-1407

NPI assigned

Sep 24, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Robin Carter-Visscher, PH.D.

Title

Licensed Psychologist

Phone

(605) 370-5665

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1474675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564617600000",
    "number": "1891244489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 S MINNESOTA AVE STE 103",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082813",
            "telephone_number": "605-370-5665",
            "fax_number": "866-277-1407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 S MINNESOTA AVE STE 103",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082813",
            "telephone_number": "605-370-5665",
            "fax_number": "866-277-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-24",
        "last_updated": "2019-08-01",
        "status": "A",
        "authorized_official_last_name": "CARTER-VISSCHER",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "605-370-5665",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "SD",
            "license": "486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Sioux Falls, SD
• Psychologist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2019; 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.