| Vincent Psychotherapy Services | |
|
757 W Benton St Iowa City IA 52246-5953 | |
| (319) 339-4757 | |
| (608) 299-1224 |
| Full Name | Vincent Psychotherapy Services |
|---|---|
| Speciality | Counselor |
| Location | 757 W Benton St, Iowa City, Iowa |
| Authorized Official Name and Position | Christine Marie Vincent (PRESIDENT) |
| Authorized Official Contact | 3193394757 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vincent Psychotherapy Services 757 W Benton St Iowa City IA 52246-5953 Ph: (319) 339-4757 | Vincent Psychotherapy Services 757 W Benton St Iowa City IA 52246-5953 Ph: (319) 339-4757 |
| NPI Number | 1508379819 |
|---|---|
| Provider Enumeration Date | 11/08/2017 |
| Last Update Date | 09/10/2019 |
| Medicare PECOS PAC ID | 5597197574 |
|---|---|
| Medicare Enrollment ID | O20191112003674 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508379819 | NPI | - | NPPES |
| 0074591 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 03057 (Iowa) | Primary |
| Provider Name | Christine M Vincent |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013014703 PECOS PAC ID: 7214944651 Enrollment ID: I20060309000676 |
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