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NPI Code Detail

MEDICARE: MS. ANTONIA VINCENT LCSW

MEDICARE: MS. ANTONIA VINCENT LCSW
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 WorkerCSW002067GA
21041C0700XClinical Social WorkerC007747NC

General Provider Information

NPI Number : 1669487385
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANTONIA VINCENT LCSW
Provider Business Mailing Address
First Line : 439 US HIGHWAY 158 W
Second Line :
City : YANCEYVILLE
State : NC
Zip : 27379-8304
Country : US
Telephone Number : 336-694-9331
Fax Number : 336-694-7511
Provider Business Practice Location Address
First Line : 439 US HIGHWAY 158 W
Second Line :
City : YANCEYVILLE
State : NC
Zip : 27379-8304
Country : US
Telephone Number : 336-694-9331
Fax Number : 336-694-7511
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2006
Last Update Date : 10/04/2022

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Directions to “ MS. ANTONIA VINCENT LCSW” Practice Location

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