AUTHENTIC VIBRANCY COMPANY PLLC
NPI 1245116680
Counselor - Mental Health in Mount Vernon, WA
About Authentic Vibrancy Company Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AUTHENTIC VIBRANCY COMPANY PLLC (NPI 1245116680) is a healthcare organization registered as a mental health in Mount Vernon, Washington and active in the NPI registry since August 2025. The organization lists Tracy Wiesneske, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Authentic Vibrancy Company Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Authentic Vibrancy Company PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Authentic Vibrancy Company PLLC's NPI number?
The NPI number for Authentic Vibrancy Company PLLC is 1245116680. It was assigned to this organization in the NPPES registry on August 12, 2025.
Where is Authentic Vibrancy Company PLLC located?
Authentic Vibrancy Company PLLC is located at 325 Pine St Ste B, Mount Vernon, WA 98273. The listed phone number is (360) 420-5930.
What is Authentic Vibrancy Company PLLC's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Authentic Vibrancy Company PLLC enrolled in Medicare?
Yes. Authentic Vibrancy Company PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Authentic Vibrancy Company PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Mental Health Counselor) reassigns their Medicare billing to Authentic Vibrancy Company PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Authentic Vibrancy Company PLLC was last updated on August 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Authentic Vibrancy Company Pllc · NPI 1245116680
Mental Health organization in Mount Vernon, Washington. Organization record, active in the CMS NPPES registry since August 12, 2025.
## Identity
- **NPI:** 1245116680 (Entity type: Organization)
- **Enumerated:** August 12, 2025
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **Organization subpart:** No
- **Authorized official:** Tracy Wiesneske, OWNER
## Practice location
- **Address:** 325 PINE ST STE B, Mount Vernon, WA 98273-5929
- **Phone:** (360) 420-5930 · **Fax:** (360) 499-2274
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Mental Health Counselor) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 12, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1245116680) · Data from the CMS NPPES public registry.