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NPI Code Detail

MEDICARE: VIVIAN LOUISE PINNER M. ED., LMHC, NCC

MEDICARE: VIVIAN LOUISE PINNER M. ED., LMHC, NCC
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
1101YM0800XMental Health CounselorMH 6828FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1831466945
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIVIAN LOUISE PINNER M. ED., LMHC, NCC
Provider Business Mailing Address
First Line : PO BOX 748519
Second Line :
City : ATLANTA
State : GA
Zip : 30374-8519
Country : US
Telephone Number : 904-376-3800
Fax Number : 904-376-3998
Provider Business Practice Location Address
First Line : 4844 DEER LAKE DR W STE 101
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32246-4406
Country : US
Telephone Number : 904-376-3800
Fax Number : 904-390-7431
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2011
Last Update Date : 01/24/2023

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