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General NPI Number Information
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NPI Number | 1043997596
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Entity Type | Organization
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Legal Business Name | VITALITY COUNSELING CENTER LLC
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Dates
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Enumeration Date | 06/28/2023
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | 40 GARDENVILLE PKWY W STE 114
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City | WEST SENECA
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State | NY
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Zip | 14224-1387
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Country | US
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Telephone | 716-202-8428
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Fax |
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Provider Business Mailing Address
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Address Line | 270 S HUXLEY DR
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City | CHEEKTOWAGA
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State | NY
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Zip | 14225-1614
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER, THERAPIST, SUPERVISOR
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Name | NATALIE J FRAIZE
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Credential | LMHC, LPC
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Telephone | 716-202-8428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 224Y00000X
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Taxonomy Name | Clinical Exercise Physiologist
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License Number |
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License Number State |
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