MEDICARE: MICHELLE ELAINE VITALE

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1265373526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE ELAINE VITALE

Provider Business Mailing Address
First Line	:	42 BUNTING AVE
Second Line	:
City	:	MARTINSBURG
State	:	WV
Zip	:	25405-3938
Country	:	US
Telephone Number	:	304-620-5416
Fax Number	:

Provider Business Practice Location Address
First Line	:	229 E MARTIN ST STE 6
Second Line	:
City	:	MARTINSBURG
State	:	WV
Zip	:	25401-3367
Country	:	US
Telephone Number	:	304-260-6360
Fax Number	:	304-260-6459

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

Provider Enumeration Date	:	04/02/2026
Last Update Date	:	04/02/2026

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Directions to “ MICHELLE ELAINE VITALE ” Practice Location

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