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NPI Code Detail

MEDICARE: CHANDRA ROSE VINCENT

MEDICARE: CHANDRA ROSE VINCENT
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

General Provider Information

NPI Number : 1972303113
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHANDRA ROSE VINCENT
Provider Business Mailing Address
First Line : 1918 VISTA ST APT 108
Second Line :
City : BELLE FOURCHE
State : SD
Zip : 57717-2259
Country : US
Telephone Number : 605-569-6977
Fax Number :
Provider Business Practice Location Address
First Line : 310 S 26TH ST STE 1
Second Line :
City : SPEARFISH
State : SD
Zip : 57783-3355
Country : US
Telephone Number : 605-580-7358
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2025
Last Update Date : 03/17/2025

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Directions to “ CHANDRA ROSE VINCENT ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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