Provider Demographics
NPI:1912777038
Name:MICHELE VINCENT LCSW PLLC
Entity Type:Organization
Organization Name:MICHELE VINCENT LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:VINCENT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWR
Authorized Official - Phone:917-496-7328
Mailing Address - Street 1:63 CYPRESS ST
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-3422
Mailing Address - Country:US
Mailing Address - Phone:917-496-7328
Mailing Address - Fax:
Practice Address - Street 1:48 CARNATION AVE
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-1734
Practice Address - Country:US
Practice Address - Phone:917-496-7328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty