Active NPI
Kyna Vincent
- Counselor
- Olney, IL
National Provider Identifier
1073843009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 504 Micah Dr
Drawer M
Olney, IL 62450-4720 - Phone
- (618) 395-4306
- Fax
- (618) 395-4507
- NPI assigned
- Jan 14, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary | ||
| Mental Health Counselor | 101YM0800X |
Addresses
Primary practice location
504 Micah Dr
Drawer M
Olney, IL 62450-4720
Mailing address
504 Micah Dr
Drawer M
Olney, IL 62450-4720
Phone (618) 395-4306
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263427200000",
"number": "1073843009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 MICAH DR",
"address_2": "DRAWER M",
"city": "OLNEY",
"state": "IL",
"postal_code": "624504720",
"telephone_number": "618-395-4306",
"fax_number": "618-395-4507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "504 MICAH DR",
"address_2": "DRAWER M",
"city": "OLNEY",
"state": "IL",
"postal_code": "624504720",
"telephone_number": "618-395-4306",
"fax_number": "618-395-4507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VINCENT",
"first_name": "KYNA",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-14",
"last_updated": "2010-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olney, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.