Vital Minds, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

VITAL MINDS, LLC

Practice address

9122 Montgomery Rd Ste 18
Cincinnati, OH 45242-7746

Phone

(513) 268-8575

Fax

(512) 268-2052

NPI assigned

Oct 5, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Kelly Ann Ickes, PSYDNPI 1669704680

Title

Psychologist/Owner

Phone

(513) 268-8575

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Kelly Ann Ickes, PSYD

  • Clinical Psychologist
  • Cincinnati, OH
  • NPI 1669704680
  NPD Authorized official

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

{
    "created_epoch": "1696464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1902687932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9292 STEEPLECHASE DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452424637",
            "telephone_number": "513-268-8575",
            "fax_number": "513-268-2052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9122 MONTGOMERY RD STE 18",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452427746",
            "telephone_number": "513-268-8575",
            "fax_number": "512-268-2052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL MINDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-05",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A",
        "authorized_official_last_name": "ICKES",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "513-268-8575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Visjager, APRN
• Dean Visk, MSN RN
• Jessica L Vissing
• Vital Caregivers of Ohio
• Vital Labs LLC
• Vital Testing Solutions LLC
• Sarah Rose Vitale-Santana, PSYD
• David Vitale
• Vitalvoyagellc
• Vitas Healthcare Corporation of Ohio

• Clinical Psychologist in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.