Casey Malia Vincent, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

40088 Issued in ID

Practice address

740 McKinley Ave
Kellogg, ID 83837-2693

Phone

(208) 783-1267

NPI assigned

Jun 27, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

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.

• Dirne Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Coeur D Alene, ID
  • NPI 1194397240

  Mental Health

  NPD
• Dirne Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Coeur D Alene, ID
  • NPI 1285686477

  Social Worker

  NPD
• Dirne Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Post Falls, ID
  • NPI 1841696952

  Social Worker

  NPD

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1679094940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1387",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838351387",
            "telephone_number": "208-415-0299",
            "fax_number": "208-625-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 MCKINLEY AVE",
            "city": "KELLOGG",
            "state": "ID",
            "postal_code": "838372693",
            "telephone_number": "208-783-1267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "CASEY",
        "middle_name": "MALIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-27",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LMSW-36778",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "36778",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "40088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "36778",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joanne Elizabeth Swiatek
• Darrel Steven Swyter, CDP
• Up the Draw LLC
• Farah Esther Vega, MD
• Adrianne Inez Vest, PTA
• Garret N Wendt, PHARMD
• Richard Lee Wilgus
• Rusty M Wood, MPT
• Valerie Wood, OTR/L
• Tony Wright

• Clinical Social Worker in Kellogg, ID
• Providers in Kellogg, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.