Provider Demographics
NPI:1003792227
Name:VIBRANT MIND THERAPY PLLC
Entity type:Organization
Organization Name:VIBRANT MIND THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:WADE
Authorized Official - Middle Name:P
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-891-2120
Mailing Address - Street 1:107 TWISTED OAK PL
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-5567
Mailing Address - Country:US
Mailing Address - Phone:765-891-2120
Mailing Address - Fax:
Practice Address - Street 1:15000 WESTON PKWY OFC 148
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-2118
Practice Address - Country:US
Practice Address - Phone:765-891-2120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty