Annalissa G. Vicencio, MA, LCAT, MT-BC

Primary specialty

Music TherapistTaxonomy code 225A00000X

License

002111 Issued in NY

Practice address

205 W 15TH St Apt 2E
New York, NY 10011-6414

Phone

(914) 481-2283

Fax

(888) 651-4682

NPI assigned

Jul 8, 2020

Last updated

Jul 8, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1649898453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W 15TH ST APT 2E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100116414",
            "telephone_number": "914-481-2283",
            "fax_number": "888-651-4682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W 15TH ST APT 2E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100116414",
            "telephone_number": "914-481-2283",
            "fax_number": "888-651-4682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICENCIO",
        "first_name": "ANNALISSA",
        "middle_name": "G.",
        "credential": "MA, LCAT, MT-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-08",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225A00000X",
            "taxonomy_group": "",
            "desc": "Music Therapist",
            "state": null,
            "license": "12125",
            "primary": false
        },
        {
            "code": "225A00000X",
            "taxonomy_group": "",
            "desc": "Music Therapist",
            "state": "NY",
            "license": "002111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie Josephe Viard, M.D.
• Kati Viassy
• Vibe Therapy, LCSW PLLC
• Michelle E. Vicari, MSPT
• Grace Marie Rendon Vicen, PT
• Vicente J Liz Defillo
• Lisa Christine Vicente, CASAC-T
• Pratya Vichetpitayapong, RN
• Monique Vickerie
• Adrienne Vickers, MD

• Music Therapist in New York, NY
• Providers in New York, NY by specialty
• Music Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; 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.