Ivelisse Vicente Licsw

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

IVELISSE VICENTE LICSW

Practice address

62 Leona Ave
Chicopee, MA 01013-3319

Phone

(413) 377-0677

NPI assigned

Jul 25, 2024

Organization subpart

No

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

Authorized official

Name

Ivelisse Vicente, LICSWNPI 1477818532

Title

Psychotherapist

Phone

(413) 377-0677

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ivelisse Vicente, LCSW

  • Clinical Social Worker
  • West Springfield, MA
  • NPI 1477818532
  NPD Authorized official

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

{
    "created_epoch": "1721865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721865600000",
    "number": "1982432324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1086",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010211086",
            "telephone_number": "413-377-0677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 LEONA AVE",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010133319",
            "telephone_number": "413-377-0677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVELISSE VICENTE LICSW",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-25",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "VICENTE",
        "authorized_official_first_name": "IVELISSE",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "413-377-0677",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Chicopee, MA
• Providers in Chicopee, MA by specialty
• Community/Behavioral Health Agency in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.