Provider Demographics
NPI:1972391654
Name:VIRIDITAS LLC
Entity type:Organization
Organization Name:VIRIDITAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KATYA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-315-4644
Mailing Address - Street 1:957 MOSQUITO VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17702-8729
Mailing Address - Country:US
Mailing Address - Phone:401-315-4644
Mailing Address - Fax:
Practice Address - Street 1:1307 PARK AVE STE 10-223
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-4590
Practice Address - Country:US
Practice Address - Phone:401-315-4644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty