Individual provider Active NPI

Vincent Intersimone

  • Marriage & Family Therapist
  • Philadelphia, PA
National Provider Identifier
1790616753
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
7901 Bustleton Ave Ste 300
Philadelphia, PA 19152-3330
Phone
(215) 320-3200
NPI assigned
May 28, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

7901 Bustleton Ave Ste 300
Philadelphia, PA 19152-3330

Mailing address

449 W Norris St Apt 2
Philadelphia, PA 19122-2250
Phone (650) 996-2037

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1779926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1790616753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "449 W NORRIS ST APT 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191222250",
            "telephone_number": "650-996-2037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 BUSTLETON AVE STE 300",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191523330",
            "telephone_number": "215-320-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INTERSIMONE",
        "first_name": "VINCENT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-05-28",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; 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.