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NPI Code Detail

MEDICARE: MICHELE VINCENT, LCSW, LLC

MEDICARE: MICHELE VINCENT, LCSW, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker4274LA

General Provider Information

NPI Number : 1851705156
Entity Type Code : Organization
Provider Name (Legal Business Name) : MICHELE VINCENT, LCSW, LLC
Provider Business Mailing Address
First Line : 204 OAK HILL LN
Second Line :
City : YOUNGSVILLE
State : LA
Zip : 70592-6170
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 115 HANSEL ST
Second Line :
City : NEW IBERIA
State : LA
Zip : 70560-5039
Country : US
Telephone Number : 337-257-9333
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MICHELE R VINCENT
Credential : LCSW
Telephone Number : 337-257-9333
Provider Enumeration Date : 06/13/2014
Last Update Date : 06/13/2014

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Directions to “MICHELE VINCENT, LCSW, LLC ” Practice Location

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