Provider Demographics
NPI:1518231562
Name:VINCENT, CHRISTEL (MS, MFT-INTERN)
Entity Type:Individual
Prefix:MS
First Name:CHRISTEL
Middle Name:
Last Name:VINCENT
Suffix:
Gender:F
Credentials:MS, MFT-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9488 W FLAMINGO RD STE 102
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-5717
Mailing Address - Country:US
Mailing Address - Phone:702-907-4325
Mailing Address - Fax:
Practice Address - Street 1:9488 W FLAMINGO RD STE 102
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147
Practice Address - Country:US
Practice Address - Phone:702-907-4325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-07
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMI0593106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1518231562Medicaid