Theresa M Vincent, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

1241 Issued in MA

Practice address

200 Silver St
Unit 106
Agawam, MA 01001-3065

Phone

(413) 789-9198

Fax

(413) 789-6322

NPI assigned

Aug 12, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Theresa M Martin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1281571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281571200000",
    "number": "1063727170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SILVER ST",
            "address_2": "UNIT 106",
            "city": "AGAWAM",
            "state": "MA",
            "postal_code": "010013065",
            "telephone_number": "413-789-9198",
            "fax_number": "413-789-6322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SILVER ST",
            "address_2": "UNIT 106",
            "city": "AGAWAM",
            "state": "MA",
            "postal_code": "010013065",
            "telephone_number": "413-789-9198",
            "fax_number": "413-789-6322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "THERESA",
        "middle_name": "M",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-12",
        "last_updated": "2010-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "1241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "MARTIN",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mental Health Counselor in Agawam, MA
• Providers in Agawam, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.