Antonia Vincent, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C007747 Issued in NC

Practice address

439 US Highway 158 W
Yanceyville, NC 27379-8304

Phone

(336) 694-9331

Fax

(336) 694-7511

NPI assigned

Jul 30, 2006

Sex

Female

Sole proprietor

No

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)

Enrolled

State licenses

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1669487385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "439 US HIGHWAY 158 W",
            "city": "YANCEYVILLE",
            "state": "NC",
            "postal_code": "273798304",
            "telephone_number": "336-694-9331",
            "fax_number": "336-694-7511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 US HIGHWAY 158 W",
            "city": "YANCEYVILLE",
            "state": "NC",
            "postal_code": "273798304",
            "telephone_number": "336-694-9331",
            "fax_number": "336-694-7511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4318 Allgood Way",
            "address_purpose": "LOCATION",
            "city": "Stone Mountain",
            "state": "GA",
            "postal_code": "300834808",
            "country_code": "US",
            "telephone_number": "404-292-4338",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "602 Millwood School Rd",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274099683",
            "country_code": "US",
            "telephone_number": "678-978-7121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "ANTONIA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-30",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW002067",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C007747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anya Tilly, OTR/L
• Trinity Behavioral Healthcare PC
• Myranda Tuck
• Two Rivers Physician Practices, LLC
• Jill Elaine Van Horn, DO
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-3036)
• Anna Elizabeth Whited, NCMHCA
• David Fielding Willis, M.D.
• Miranda G Worley, PA-C
• WP-Yanceyville Health Holdings, LLC (Caswell House)

• Clinical Social Worker in Yanceyville, NC
• Providers in Yanceyville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.