Provider Demographics
NPI:1205385531
Name:SMRIGLIO, VINCENZO (LCSW)
Entity Type:Individual
Prefix:MR
First Name:VINCENZO
Middle Name:
Last Name:SMRIGLIO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:JIMMY
Other - Middle Name:
Other - Last Name:SMRIGLIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 3571
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-0571
Mailing Address - Country:US
Mailing Address - Phone:940-228-6373
Mailing Address - Fax:
Practice Address - Street 1:1016 COVINGTON ST
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76306-5837
Practice Address - Country:US
Practice Address - Phone:940-228-6373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical