# VITALITY FAMILY MENTAL HEALTH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790224939
- **Authorized official:** DR. ALBERT NORMAN BROWN II (PRESIDENT)
- **Authorized official phone:** (612) 200-0866

## Contact information

- **Practice address:** 4149 LYNDALE AVE N, SUITE 107, MINNEAPOLIS, MN 55412-1703
- **Practice address phone:** (612) 200-0866
- **Practice address fax:** (612) 520-5662
- **Mailing address:** 4149 LYNDALE AVE N, SUITE 107, MINNEAPOLIS, MN 55412-1703
- **Mailing address phone:** (612) 200-0866
- **Mailing address fax:** (612) 520-5662

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 302652 | MN | — |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | 302652 | MN | — |
| 103TB0200X | Cognitive & Behavioral Psychologist | — | NULL | — |
| 103TB0200X | Cognitive & Behavioral Psychologist | — | — | — |
| 103TC1900X | Counseling Psychologist | — | NULL | — |
| 103TC1900X | Counseling Psychologist | — | — | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | NULL | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | — |
| 103TF0000X | Family Psychologist | — | NULL | — |
| 103TF0000X | Family Psychologist | — | — | — |
| 103TP2701X | Group Psychotherapy Psychologist | — | NULL | — |
| 103TP2701X | Group Psychotherapy Psychologist | — | — | — |
| 1041C0700X | Clinical Social Worker | 24498 | MN | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 02/21/2017
- **Last updated:** 02/21/2017