Vincent Counseling, LLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LCA139 Issued in MD

Legal business name

VINCENT COUNSELING, LLC

Practice address

7519 Haines CT
Laurel, MD 20707-3345

Phone

(443) 303-9205

NPI assigned

Feb 11, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Tara M Woodard

Title

Office Manager

Phone

(667) 200-7175

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1486771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486771200000",
    "number": "1245778166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7519 HAINES CT",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207073345",
            "telephone_number": "443-303-9205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7519 HAINES CT",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207073345",
            "telephone_number": "443-303-9205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINCENT COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-11",
        "last_updated": "2017-02-11",
        "status": "A",
        "authorized_official_last_name": "WOODARD",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "667-200-7175",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "DC",
            "license": "PRC11",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "LCA139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "905028",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2017; 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.