Provider Demographics
NPI:1467732206
Name:VINTON, JOAN C (LADC,CCS,MHRT-C)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:C
Last Name:VINTON
Suffix:
Gender:F
Credentials:LADC,CCS,MHRT-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 820
Mailing Address - Street 2:147 SHAKER HILL ROAD
Mailing Address - City:ALFRED
Mailing Address - State:ME
Mailing Address - Zip Code:04002-0820
Mailing Address - Country:US
Mailing Address - Phone:207-324-1137
Mailing Address - Fax:207-324-5290
Practice Address - Street 1:147 SHAKER HILL RD
Practice Address - Street 2:
Practice Address - City:ALFRED
Practice Address - State:ME
Practice Address - Zip Code:04002-3253
Practice Address - Country:US
Practice Address - Phone:207-324-1137
Practice Address - Fax:207-324-5290
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC200101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)