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1831872902

NPI Code Detail

MEDICARE: SREYA VEMULA

MEDICARE: SREYA VEMULA

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	100375	TX
2	101YM0800X	Mental Health Counselor	MC61677637	WA
3	101YM0800X	Mental Health Counselor	CTB-2026-0186	NM
4	101YM0800X	Mental Health Counselor	R11038	OR

General Provider Information

NPI Number	:	1831872902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SREYA VEMULA

Provider Business Mailing Address
First Line	:	25210 SE 42ND DR
Second Line	:
City	:	SAMMAMISH
State	:	WA
Zip	:	98029-5788
Country	:	US
Telephone Number	:	501-503-3305
Fax Number	:

Provider Business Practice Location Address
First Line	:	4700 IRVING BLVD NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87114-4283
Country	:	US
Telephone Number	:	866-727-8274
Fax Number	:

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

Provider Enumeration Date	:	08/07/2023
Last Update Date	:	03/23/2026

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Directions to “ SREYA VEMULA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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