Provider Demographics
NPI:1275900565
Name:MARY V. SOIGNET, LLC
Entity Type:Organization
Organization Name:MARY V. SOIGNET, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:V
Authorized Official - Last Name:SOIGNET
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:985-447-5383
Mailing Address - Street 1:102 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-3402
Mailing Address - Country:US
Mailing Address - Phone:985-447-5383
Mailing Address - Fax:985-447-5384
Practice Address - Street 1:102 E 5TH ST
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-3402
Practice Address - Country:US
Practice Address - Phone:985-447-5383
Practice Address - Fax:985-447-5384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-21
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA37011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty