Courtney Marie Vincent, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801118077 Issued in MI

Practice address

209 E Washington Ave Ste 430
Jackson, MI 49201-2393

Phone

(517) 262-7189

NPI assigned

Apr 5, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Everbloom Counseling & Wellness

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jackson, MI
  • NPI 1578411831
  NPD Authorized official

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1649911595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 E WASHINGTON AVE STE 430",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012393",
            "telephone_number": "517-262-7189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 E WASHINGTON AVE STE 430",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012393",
            "telephone_number": "517-262-7189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "COURTNEY",
        "middle_name": "MARIE",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801118077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thrivecounselingwellness@outlook.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8288 N Shore Dr",
            "city": "Clarklake",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492349792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stephanie Videan, CPNP-PC
• Teresa Vigor, PHARMD
• Bridget Katherine Villarreal, DC
• Crystal Villarreal
• Heidi J Vinaske
• Seth Vincent
• Dana Therese Virgo, M.D.
• Gurpinderjit Virk, MD
• Visiting Doctors PC
• Vista Grande Villa

• Clinical Social Worker in Jackson, MI
• Providers in Jackson, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.