Vincent Buckholz, Licsw, PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

0890114807 Issued in VT

Legal business name

VINCENT BUCKHOLZ, LICSW, PLLC

Doing business as

Counter Balance

Practice address

56 Main St Ste 212
Springfield, VT 05156-2945

Phone

(802) 692-0697

NPI assigned

Feb 7, 2018

Last updated

Feb 12, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vincent Buckholz, LICSWNPI 1972036432

Title

Owner

Phone

(802) 692-0697

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Counter Balance Doing business as

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

Tax ID family

Counter Balance2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Counter Balance

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Springfield, VT
  • NPI 1003315177
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vincent Buckholz, LICSW

  • Clinical Social Worker
  • Springfield, VT
  • NPI 1972036432
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1517961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518393600000",
    "number": "1902305782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 MAIN ST STE 212",
            "city": "SPRINGFIELD",
            "state": "VT",
            "postal_code": "051562945",
            "telephone_number": "802-692-0697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 MAIN ST STE 212",
            "city": "SPRINGFIELD",
            "state": "VT",
            "postal_code": "051562945",
            "telephone_number": "802-692-0697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINCENT BUCKHOLZ, LICSW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-07",
        "last_updated": "2018-02-12",
        "status": "A",
        "authorized_official_last_name": "BUCKHOLZ",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "802-692-0697",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "VT",
            "license": "0890114807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1030150",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Counter Balance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Melanie Walker
• Mark Steven Walkup, LICSW
• Fang Wang

• Mental Health Clinic/Center (Including Community Mental Health Center) in Springfield, VT
• Providers in Springfield, VT by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.