Active NPI
Troy Larry Vincent Sr., LAC
- Mental Health Counselor
- Newport, AR
National Provider Identifier
1275748725
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- A0704036
- Practice address
- 1507 N. Pecan St.
Newport, AR 72112 - Phone
- (870) 523-3643
- NPI assigned
- May 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | A0704036 | AR | Primary |
Addresses
Primary practice location
1507 N. Pecan St.
Newport, AR 72112
Mailing address
PO Box 2306
State University, AR 72467-2306
Phone (870) 258-8116
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A0704036 | AR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275748725",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2306",
"city": "STATE UNIVERSITY",
"state": "AR",
"postal_code": "724672306",
"telephone_number": "870-258-8116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1507 N. PECAN ST.",
"city": "NEWPORT",
"state": "AR",
"postal_code": "72112",
"telephone_number": "870-523-3643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VINCENT",
"first_name": "TROY",
"middle_name": "LARRY",
"name_prefix": "Mr.",
"name_suffix": "Sr.",
"credential": "LAC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AR",
"license": "A0704036",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.