Individual provider Active NPI

Marilyn George Vincent, LPCC-S

  • Professional Counselor
  • Blue Ash, OH
National Provider Identifier
1225587728
Registry record updated Sep 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E0700848-S Issued in OH
Practice address
10921 Reed Hartman Hwy Ste 133
Blue Ash, OH 45242-2851
Phone
(513) 984-9838
Fax
(513) 984-8075
NPI assigned
Sep 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E0700848-S OH Primary

Addresses

Primary practice location

10921 Reed Hartman Hwy Ste 133
Blue Ash, OH 45242-2851

Mailing address

10921 Reed Hartman Hwy Ste 133
Blue Ash, OH 45242-2851
Phone (513) 984-9838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240120000259 OH Practitioner - Mental Health Counselor 0042662553 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Counseling Source IncGroup PAC ID 6709772387, 51 clinicians

Practice addresses (Care Compare)

10921 Reed Hartman Hwy
Suite 133
Blue Ash, OH 45242-2851
Phone (513) 984-9838

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E0700848-SOHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Source Inc CurrentSince Dec 18, 2023 Accepting new patients

Locations

10921 Reed Hartman Hwy
Ste 133
Blue Ash, OH 45242
Phone (513) 984-9838

Organizations & group practices 1

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": "1474761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474761600000",
    "number": "1225587728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10921 REED HARTMAN HWY STE 133",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452422851",
            "telephone_number": "513-984-9838",
            "fax_number": "513-984-8075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10921 REED HARTMAN HWY STE 133",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452422851",
            "telephone_number": "513-984-9838",
            "fax_number": "513-984-8075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "MARILYN",
        "middle_name": "GEORGE",
        "credential": "LPCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-25",
        "last_updated": "2016-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E0700848-S",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Ash, OH

Sources for this page

Verify at the official NPI Registry.