Individual provider Active NPI

Vincent John McMahon, LCSW, ICSW, CDS,CDP

  • Clinical Social Worker
  • Newport, RI
National Provider Identifier
1275818676
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW02285 Issued in RI
Practice address
6 Park St
Newport, RI 02840-2104
Phone
(401) 855-1366
NPI assigned
Oct 17, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CDS00058 RI
Addiction (Substance Use Disorder) Counselor 101YA0400X CDP00186 RI
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X 008129 CT
Clinical Social Worker 1041C0700X ISW02285 RI Primary

Addresses

Primary practice location

6 Park St
Newport, RI 02840-2104

Mailing address

6 Park St
Newport, RI 02840-2104
Phone (401) 855-1366

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
CDP00186RIMDAddiction (Substance Use Disorder) Counselor
CDS00058RIMDAddiction (Substance Use Disorder) Counselor
008129CTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1275818676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 PARK ST",
            "city": "NEWPORT",
            "state": "RI",
            "postal_code": "028402104",
            "telephone_number": "401-855-1366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 PARK ST",
            "city": "NEWPORT",
            "state": "RI",
            "postal_code": "028402104",
            "telephone_number": "401-855-1366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHON",
        "first_name": "VINCENT",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "LCSW, ICSW, CDS,CDP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-17",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "RI",
            "license": "CDS00058",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "RI",
            "license": "CDP00186",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "008129",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW02285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.