Provider Demographics
NPI:1518951615
Name:VIOLA, VINCENT JAMES (PHD, LPC)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:JAMES
Last Name:VIOLA
Suffix:
Gender:M
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 GRAPEVINE MILLS PKWY UNIT 335
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-1992
Mailing Address - Country:US
Mailing Address - Phone:972-393-1596
Mailing Address - Fax:972-304-0400
Practice Address - Street 1:413 WEST BETHEL RD., #100
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019
Practice Address - Country:US
Practice Address - Phone:972-393-1596
Practice Address - Fax:972-304-0400
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX576101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor