Healthcare Provider Details

I. General information

NPI: 1245802248
Provider Name (Legal Business Name): VIBRANT LIVING SKILLS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2021
Last Update Date: 02/02/2026
Certification Date: 02/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12850 HIGHWAY 9 N STE 600-315
ALPHARETTA GA
30004-4231
US

IV. Provider business mailing address

12850 HIGHWAY 9 N STE 600-315
ALPHARETTA GA
30004-4231
US

V. Phone/Fax

Practice location:
  • Phone: 706-506-2443
  • Fax: 404-907-1248
Mailing address:
  • Phone: 706-506-2443
  • Fax: 404-907-1248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code224ZE0001X
TaxonomyEnvironmental Modification Occupational Therapy Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225XE0001X
TaxonomyEnvironmental Modification Occupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NATALIE STONE KING
Title or Position: OWNER/OCCUPATIONAL THERAPIST
Credential: OTR/L
Phone: 706-506-2443