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General NPI Number Information
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NPI Number | 1710750567
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Entity Type | Organization
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Legal Business Name | VITALITY CLINICAL SERVICES PLLC
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Dates
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Enumeration Date | 11/02/2023
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 2201 SE LOOP 820
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City | FORT WORTH
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State | TX
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Zip | 76119-5863
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Country | US
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Telephone | 817-330-4016
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Fax |
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Provider Business Mailing Address
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Address Line | 1660 S UNIVERSITY DR # 1083
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City | FORT WORTH
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State | TX
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Zip | 76107-6524
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Country | US
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Telephone | 817-330-4016
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | DR. JUSTIN LITVIN
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Credential | PHD
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Telephone | 817-330-4016
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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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 | 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 #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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