Vitalizing Care Consultants LLC

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Legal business name

VITALIZING CARE CONSULTANTS LLC

Practice address

1420 Washington Blvd Ste 301
Detroit, MI 48226

Phone

(855) 455-2274

Fax

(586) 314-0167

NPI assigned

Dec 21, 2017

Reactivated

Jan 12, 2022

Organization subpart

No

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

Authorized official

Name

Shomari McCoy, MBA

Title

Chief Executive Officer

Phone

(855) 455-2274

Specialties & licenses 11

Addresses

Other names 2

• VCC Care Services Doing business as
• Vitalizing Care Consultants Doing business as

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

{
    "created_epoch": "1513814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641945600000",
    "number": "1912413386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 180266",
            "city": "UTICA",
            "state": "MI",
            "postal_code": "483180266",
            "telephone_number": "855-455-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 WASHINGTON BLVD STE 301",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48226",
            "telephone_number": "855-455-2274",
            "fax_number": "586-314-0167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALIZING CARE CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-21",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "deactivation_date": "2021-12-21",
        "reactivation_date": "2022-01-12",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "SHOMARI",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "855-455-2274",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VCC Care Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vitalizing Care Consultants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Case Manager/Care Coordinator in Detroit, MI
• Providers in Detroit, MI by specialty
• Case Manager/Care Coordinator in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; 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.