MEDICARE: ANDREA T VINTON LPCC, LPC, MHC

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
1	101YM0800X	Mental Health Counselor	CTB-2023-0601	NM
2	101YM0800X	Mental Health Counselor	C5718	OR
3	101YM0800X	Mental Health Counselor	13043	CA
4	101YM0800X	Mental Health Counselor	LH61408460	WA

General Provider Information

NPI Number	:	1215384490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA T VINTON LPCC, LPC, MHC

Provider Business Mailing Address
First Line	:	15744 GAULT ST
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91406-5149
Country	:	US
Telephone Number	:	213-649-8092
Fax Number	:

Provider Business Practice Location Address
First Line	:	15744 GAULT ST
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91406-5149
Country	:	US
Telephone Number	:	213-649-8092
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2016
Last Update Date	:	05/24/2025

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