Provider Demographics
NPI:1528719622
Name:VINCENT PSYCHOLOGY PLLC
Entity type:Organization
Organization Name:VINCENT PSYCHOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:VINCENT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:518-423-5157
Mailing Address - Street 1:10 WERNER AVE
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-3410
Mailing Address - Country:US
Mailing Address - Phone:518-423-5157
Mailing Address - Fax:
Practice Address - Street 1:274 DELAWARE AVE STE 2B
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-1436
Practice Address - Country:US
Practice Address - Phone:518-423-5157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)