Individual provider Active NPI

Anthony Gacita Vinson, L.I.C.S.W

  • Clinical Social Worker
  • Boston, MA
National Provider Identifier
1346627197
Registry record updated Jul 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
116338 Issued in MA
Practice address
243 Charles St
Boston, MA 02114
Phone
(617) 573-3542
Fax
(617) 573-3522
NPI assigned
Apr 30, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 116338 MA Primary

Addresses

Primary practice location

243 Charles St
Boston, MA 02114

Mailing address

243 Charles St
Boston, MA 02114-3096
Phone (617) 442-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20200721004125 TX Practitioner - Clinical Social Worker 3476832270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Psychological Care Sa I LLCGroup PAC ID 5193999860, 13 clinicians

Practice addresses (Care Compare)

4635 Southwest Fwy
Suite 635
Houston, TX 77027-7112
Phone 71385000491053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
66821TXMDProfessional Counselor
116338MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Psychological Care Sa I, LLC Clinical CurrentSince Aug 3, 2020 Accepting new patients

Locations

11127 Circle Dr
Austin, TX 78736
Phone (512) 288-8844

4635 Southwest Fwy
Ste 635
Houston, TX 77027
Phone (214) 923-7777

5027 Pecan Grove Blvd
San Antonio, TX 78222
Phone (210) 333-6815

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": "1430352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1346627197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 CHARLES ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143096",
            "telephone_number": "617-442-8800",
            "fax_number": "617-442-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 CHARLES ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-573-3542",
            "fax_number": "617-573-3522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINSON",
        "first_name": "ANTHONY",
        "middle_name": "GACITA",
        "name_prefix": "Mr.",
        "credential": "L.I.C.S.W",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-30",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "116338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.