Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Carl D Vincent

Individual provider Professional Counselor · NPI 1922019991

Carl D Vincent is a Mental Health Counselor in Moline, Illinois. Qualified in 1997, 29 years ago. Practices with Southpark Psychology Ltd, a 21-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
29
Licensed in
IL
In the registry since
2006

Practice location Address checks out

2100 52nd Ave
Moline, IL 61265-6366
Phone: (309) 797-2900
Fax: (309) 797-2147
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X (IL)

Record details

NPI number1922019991
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 11, 2006
Last updated in NPPESJuly 8, 2007
Mailing address2100 52nd Ave, Moline, IL 61265-6366

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice Southpark Psychology Ltd — 21 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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