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General NPI Number Information
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NPI Number | 1740769918
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Entity Type | Individual
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Provider Name | MARCIA MICHELLE VINCENT M.A., NCC, LPC, CAS
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Gender | Female
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Dates
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Enumeration Date | 08/09/2018
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Last Update Date | 08/31/2025
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Provider Practice Location Address
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Address Line | 350 TERRY ST STE 320350
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City | LONGMONT
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State | CO
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Zip | 80501-5403
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Country | US
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Telephone | 970-310-3406
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Fax |
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Provider Business Mailing Address
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Address Line | 350 TERRY ST STE 320
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City | LONGMONT
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State | CO
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Zip | 80501-5490
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Country | US
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Telephone | 970-310-3406
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0017550
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License Number State | CO
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