=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417873555
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENNIFER LYNN VINCENT PLMHP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/24/2026
-----------------------------------------------------
Last Update Date | 06/24/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 220 W 15TH ST
-----------------------------------------------------
City | KEARNEY
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68845-6763
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 308-236-0500
-----------------------------------------------------
Fax | 308-237-5225
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8 BRANDTS LAKEWOOD
-----------------------------------------------------
City | KEARNEY
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68845-9400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 308-440-1813
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 14627
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------