Provider Demographics
NPI:1881740603
Name:VINCENT, KAREN L (LICSW)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:L
Last Name:VINCENT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:355 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH DIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02764-1822
Mailing Address - Country:US
Mailing Address - Phone:774-245-7775
Mailing Address - Fax:508-481-6680
Practice Address - Street 1:56 FRAMINGHAM RD
Practice Address - Street 2:GLENHAVEN ACADEMY
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-3260
Practice Address - Country:US
Practice Address - Phone:508-481-8077
Practice Address - Fax:508-481-6680
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1113141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical