Casey Malia Vincent, LCSW

NPI #1679094940 in Kellogg, Idaho

Provider Information

NPI Number: 1679094940
Entity Type: Individual
Name: Casey Malia Vincent, LCSW
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker - Clinical
Credential: LCSW
Enumeration Date: Jun 27, 2017
Last Updated: Oct 5, 2020

Practice Location

Address: 740 MCKINLEY AVE
City: Kellogg
State: Idaho
ZIP Code: 83837-2693
Phone: (208) 783-1267

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X
Social Worker	104100000X
Social Worker - Clinical — Clinical	1041C0700X	Primary

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