DR. JOHNATHAN VITAL PH.D.
NPI 1477810067
Clinical Neuropsychologist in Waldorf, MD

Q: What is Johnathan Vital's NPI number?

The NPI number for Johnathan Vital is 1477810067. It was assigned to this individual provider in the NPPES registry on April 19, 2012.

Q: What is Johnathan Vital's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Q: When was this NPI record last updated?

The NPPES record for Johnathan Vital was last updated on April 20, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years 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.

Active since April 19, 2012

2413 ALTENBURG CT, WALDORF, MD 20603(301) 653-8828(202) 558-7113 Get Directions Write a Review

NPPES record last updated: April 20, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr. Johnathan Vital Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JOHNATHAN VITAL PH.D. (NPI 1477810067) is an individual clinical neuropsychologist in Waldorf, Maryland, licensed in Maryland (04759) and active in the NPI registry since April 2012.

NPPES Registry Identity

NPI1477810067

Entity TypeIndividualMale

Primary Taxonomy103G00000X

Provider Legal NameDR. JOHNATHAN VITALCredential: PH.D.

Location Address2413 ALTENBURG CTWaldorf, MD 20603

Mailing Address2413 Altenburg CtWaldorf, MD 20603 · (301) 653-8828 · Fax (202) 558-7113

Phone(301) 653-8828

Fax(202) 558-7113

Sole ProprietorYes

Enumeration DateApril 19, 2012

Last NPPES UpdateApril 20, 2012

✔ NPI 1477810067 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers

Taxonomy Code103G00000X

Licenses✔ Licensed in MD · 04759✔ Licensed in DC · PSY1000614

Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

Also ListedPsychologistTaxonomy 103T00000X · License PSY1000614 (DC), 04759 (MD)

2413 ALTENBURG CT, Waldorf, MD 20603

Open in Google Maps ↗

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 Johnathan Vital's NPI number?

The NPI number for Johnathan Vital is 1477810067. It was assigned to this individual provider in the NPPES registry on April 19, 2012.

Where is Johnathan Vital located?

Johnathan Vital practices at 2413 Altenburg Ct, Waldorf, MD 20603. The listed phone number is (301) 653-8828.

What is Johnathan Vital's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

When was this NPI record last updated?

The NPPES record for Johnathan Vital was last updated on April 20, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years 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.