Wesley L Vincent, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

001556 Issued in CT

Practice address

139 Hazard Ave
Suite 7
Enfield, CT 06082-4597

Phone

(860) 763-4465

Fax

(860) 763-4467

NPI assigned

Jun 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wesley L Vincent Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351209600000",
    "number": "1396772232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 BOSTON TPKE",
            "city": "POMFRET CENTER",
            "state": "CT",
            "postal_code": "062599514",
            "telephone_number": "860-974-2994",
            "fax_number": "860-974-2994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 HAZARD AVE",
            "address_2": "SUITE 7",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824597",
            "telephone_number": "860-763-4465",
            "fax_number": "860-763-4467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "WESLEY",
        "middle_name": "L",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2012-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "001556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004134459",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WESLEY",
            "last_name": "VINCENT",
            "middle_name": "L",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Sarah Verteramo, AUD
• Scott Vibberts
• Robin Vigliani, LCSW
• Christina Vilkhovoy, DPT
• Anne Marie F Villa, M.D.
• Samantha L Violette
• Aaron M Virgo
• Isra Vohra
• Kristen Leigh Easey Wackelin, PA-C
• Walgreen Co (Walgreens #09432)

• Clinical Psychologist in Enfield, CT
• Providers in Enfield, CT by specialty
• Clinical Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2012; 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.