Individual provider Active NPI

Krista Vincent, LICSW

  • Clinical Social Worker
  • Portsmouth, NH
National Provider Identifier
1023788775
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2533 Issued in NH
Practice address
8 Greenleaf Woods Dr
Portsmouth, NH 03801-5436
Phone
(603) 422-8208
Fax
(603) 422-8218
NPI assigned
Sep 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2533 NH Primary

Addresses

Primary practice location

8 Greenleaf Woods Dr
Portsmouth, NH 03801-5436

Mailing address

311 Route 108
Somersworth, NH 03878-1522
Phone (603) 749-2346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20220104000841 NH Practitioner - Clinical Social Worker 0547651424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Elliot Professional ServicesGroup PAC ID 6103727920, 429 clinicians

Practice addresses (Care Compare)

1 Elliot Way
Manchester, NH 03103-3502
Phone (603) 622-6484

445 Cypress St
Suite 8
Manchester, NH 03103-3600
Phone (603) 552-1670

One Elliot Way
100 Elliot Cardiovascular Consultants
Manchester, NH 03103-3502
Phone (603) 627-1669

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2533NHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot Professional Services CurrentSince Oct 24, 2023 Accepting new patients
Elliot Professional Services Past Accepting new patients

Locations

445 Cypress St
Ste 8
Manchester, NH 03103
Phone (603) 552-1670

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

Organizations & group practices 2

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": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1023788775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 ROUTE 108",
            "city": "SOMERSWORTH",
            "state": "NH",
            "postal_code": "038781522",
            "telephone_number": "603-749-2346",
            "fax_number": "603-953-0066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 GREENLEAF WOODS DR",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038015436",
            "telephone_number": "603-422-8208",
            "fax_number": "603-422-8218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "KRISTA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "2533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, NH

Sources for this page

Verify at the official NPI Registry.