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NPI Code Detail

MEDICARE: VIVENT HEALTH INC

MEDICARE: VIVENT HEALTH INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2101YP2500XProfessional Counselor
3261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770721607
Entity Type Code : Organization
Provider Name (Legal Business Name) : VIVENT HEALTH INC
Provider Business Mailing Address
First Line : PO BOX 18412
Second Line :
City : PALATINE
State : IL
Zip : 60055-8440
Country : US
Telephone Number : 866-525-5484
Fax Number : 833-394-4961
Provider Business Practice Location Address
First Line : 1311 N 6TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53212-4006
Country : US
Telephone Number : 414-223-6800
Fax Number : 414-273-2357
Authorized Official
Title or Position : SR. DIRECTOR OF CORPORATE SERVICES
Name : JOANN BERK
Credential :
Telephone Number : 414-225-1568
Provider Enumeration Date : 01/30/2009
Last Update Date : 03/25/2026

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