1023144870 NPI number — MRS. VIVIAN CELESTE CRITES LCISW,LMFT,LCDC,SAP

Table of content: MRS. VIVIAN CELESTE CRITES LCISW,LMFT,LCDC,SAP (NPI 1023144870)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023144870 NPI number — MRS. VIVIAN CELESTE CRITES LCISW,LMFT,LCDC,SAP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CRITES
Provider First Name:
VIVIAN
Provider Middle Name:
CELESTE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCISW,LMFT,LCDC,SAP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CUBANO DE CRITES
Provider Other First Name:
VIVIAN
Provider Other Middle Name:
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCISW,LMFT,LCDC,SAP
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1023144870
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9100 PORT OF SALE MALL
Provider Second Line Business Mailing Address:
SUITE #15
Provider Business Mailing Address City Name:
ST THOMAS
Provider Business Mailing Address State Name:
VI
Provider Business Mailing Address Postal Code:
00802-3602
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
340-777-9393
Provider Business Mailing Address Fax Number:
340-775-3983

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4004 RHYMER HIGHWAY
Provider Second Line Business Practice Location Address:
SUITE 2-5 DOCTOR'S PARK II
Provider Business Practice Location Address City Name:
ST. THOMAS
Provider Business Practice Location Address State Name:
VI
Provider Business Practice Location Address Postal Code:
00802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
340-777-9363
Provider Business Practice Location Address Fax Number:
340-775-3983
Provider Enumeration Date:
02/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  1-2027479-2007 , registered in the state of VI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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