Provider Demographics
NPI:1093343592
Name:VISTA COUNSELING AND CONSULTATION SERVICES, LLC
Entity Type:Organization
Organization Name:VISTA COUNSELING AND CONSULTATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LACHANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS-PRIM
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:334-245-4080
Mailing Address - Street 1:7358 US HIGHWAY 231
Mailing Address - Street 2:
Mailing Address - City:WETUMPKA
Mailing Address - State:AL
Mailing Address - Zip Code:36092-2053
Mailing Address - Country:US
Mailing Address - Phone:334-245-4080
Mailing Address - Fax:334-269-7826
Practice Address - Street 1:7358 US HIGHWAY 231
Practice Address - Street 2:
Practice Address - City:WETUMPKA
Practice Address - State:AL
Practice Address - Zip Code:36092-2053
Practice Address - Country:US
Practice Address - Phone:334-245-4080
Practice Address - Fax:334-269-7826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-30
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health