# VIVIDLY VITALITY MENTORING & COUNSEL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Vividly Vitality Mentoring & Counsel, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154089696
- **Authorized official:** MS. TALENCIA ARLICIA WALKER MSW (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (480) 484-8647

## Contact information

- **Practice address:** 920 S TERRACE RD UNIT 5035, TEMPE, AZ 85281-3805
- **Practice address phone:** (480) 482-8647
- **Practice address fax:** (480) 936-0000
- **Mailing address:** 920 S TERRACE RD UNIT 5035, TEMPE, AZ 85281-3805
- **Mailing address phone:** (480) 482-8647
- **Mailing address fax:** (480) 936-0000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 12/01/2021
- **Last updated:** 12/01/2021