Active NPI
Jordan Vincent, L.I.S.W
- Clinical Social Worker
- Athens, OH
National Provider Identifier
1922459569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I1600082
- Practice address
- 18 N College St
Athens, OH 45701-2436 - Phone
- (740) 594-8337
- NPI assigned
- Jun 24, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I1600082 | OH | Primary |
Addresses
Primary practice location
18 N College St
Athens, OH 45701-2436
Mailing address
PO Box 1158
Athens, OH 45701-1158
Phone (740) 594-8337
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154357721 | Other | NATIONAL PROVIDER IDENTIFIER | |
| 2871441 | Medicaid | OH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I1600082 | OH | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466726400000",
"number": "1922459569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1158",
"city": "ATHENS",
"state": "OH",
"postal_code": "457011158",
"telephone_number": "740-594-8337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 N COLLEGE ST",
"city": "ATHENS",
"state": "OH",
"postal_code": "457012436",
"telephone_number": "740-594-8337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VINCENT",
"first_name": "JORDAN",
"credential": "L.I.S.W",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-24",
"last_updated": "2016-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "I1600082",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL PROVIDER IDENTIFIER",
"identifier": "1154357721",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2871441",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Athens, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.