Individual provider Active NPI

Christine Marie Vincent, LISW

  • Mental Health Counselor
  • Iowa City, IA
National Provider Identifier
1013014703
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
03057 Issued in IA
Practice address
757 W Benton St
Iowa City, IA 52246-5953
Phone
(319) 339-4757
NPI assigned
Sep 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 03057 IA Primary

Addresses

Primary practice location

757 W Benton St
Iowa City, IA 52246-5953

Mailing address

369 E College St
Iowa City, IA 52240-1690
Phone (319) 339-4757

Other identifiers 1

IdentifierTypeStateIssuer
39249OtherIABCBS PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060309000676 IA Practitioner - Clinical Social Worker 7214944651 Reassigns benefits to 1 organization
Practice locations: Iowa City, IA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

757 W Benton St
Iowa City, IA 52246-5953
Phone 31933947572

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Mental Health Center for Mid-Eastern Iowa PastSince Mar 23, 1994 Accepting new patients
Abbe Center for Community Mental Health, Inc Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1013014703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "369 E COLLEGE ST",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522401690",
            "telephone_number": "319-339-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 W BENTON ST",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522465953",
            "telephone_number": "319-339-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "CHRISTINE",
        "middle_name": "MARIE",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "03057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "39249",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.