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NPI Code Detail

MEDICARE: MS. ELIZABETH ERIN VICENTE LICSW MLADC

MEDICARE: MS. ELIZABETH ERIN VICENTE LICSW MLADC
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
1101YM0800XMental Health Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215129176
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELIZABETH ERIN VICENTE LICSW MLADC
Provider Business Mailing Address
First Line : 12 GREYSTONE TER
Second Line :
City : HOOKSETT
State : NH
Zip : 03106-2186
Country : US
Telephone Number : 603-731-3173
Fax Number :
Provider Business Practice Location Address
First Line : 753 CHESTNUT ST
Second Line :
City : MANCHESTER
State : NH
Zip : 03104-3011
Country : US
Telephone Number : 603-836-5004
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2007
Last Update Date : 07/02/2024

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