Individual
ELYSE VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, MC
Contact information
Practice address
4646 E GREENWAY RD STE 100, PHOENIX, AZ 85032-4805
(679) 294-9981
Mailing address
14114 W CHARTER OAK RD, SURPRISE, AZ 85379-5512
(623) 236-6978
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
LPC-22844
AZ
Other
Enumeration date
07/22/2024
Last updated
07/31/2024
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