Doctor Name: | EDMUND VINCENT |
NPI Number: | 1326307380 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | 44SG00596400 |
Business Practice Address: | 566 Haddon Ave Collingswood, NJ - 081081444 |
Business Phone Number: | 8568589314 |
Business Fax Number: | 8568585672 |
Mailing Address: | 1000 Atlantic Ave, 5th Floor CAMDEN |
State: | NJ |
Postal Code: | 081041132 |
Phone Number: | 8569643955 |
Fax Number: | 8569649332 |
NPI Enumeration Date: | 05/11/2012 |
NPI Last Update Date: | 05/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 44SG00596400 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |