Provider Demographics
NPI:1437657160
Name:VITALITY COUNSELING, INC
Entity Type:Organization
Organization Name:VITALITY COUNSELING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:REAGAN
Authorized Official - Middle Name:REESE
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC
Authorized Official - Phone:912-421-1000
Mailing Address - Street 1:135 GOSHEN ROAD EXT STE 203
Mailing Address - Street 2:
Mailing Address - City:RINCON
Mailing Address - State:GA
Mailing Address - Zip Code:31326-5569
Mailing Address - Country:US
Mailing Address - Phone:912-421-1188
Mailing Address - Fax:912-421-1189
Practice Address - Street 1:135 GOSHEN ROAD EXT STE 256
Practice Address - Street 2:
Practice Address - City:RINCON
Practice Address - State:GA
Practice Address - Zip Code:31326-5575
Practice Address - Country:US
Practice Address - Phone:912-421-1000
Practice Address - Fax:912-421-1189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-29
Last Update Date:2023-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty