Provider Demographics
NPI:1629022843
Name:VITERI, MARIA CONSUELO (LPC)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:CONSUELO
Last Name:VITERI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2232 CAHABA VALLEY DR STE C
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-9606
Mailing Address - Country:US
Mailing Address - Phone:205-541-4047
Mailing Address - Fax:205-541-4047
Practice Address - Street 1:2232 CAHABA VALLEY DRIVE
Practice Address - Street 2:SUITE C
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242
Practice Address - Country:US
Practice Address - Phone:205-541-4047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1694101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51524770OtherBLUE CROSS BLUE SHIELD
AL51192235OtherBLUE CROSS BLUE SHIELD
AL51525661OtherBLUE CROSS BLUE SHIELD
AL6229138OtherALLKIDS INSURANCE (UBH)