Provider Demographics
NPI:1437922895
Name:VIGIL, DUSTY LYNNE (MS, LPC, LCDC)
Entity Type:Individual
Prefix:MRS
First Name:DUSTY
Middle Name:LYNNE
Last Name:VIGIL
Suffix:
Gender:F
Credentials:MS, LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 OLYMPIA DR STE 200
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1855
Mailing Address - Country:US
Mailing Address - Phone:469-686-9911
Mailing Address - Fax:
Practice Address - Street 1:2301 OLYMPIA DR STE 200
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1855
Practice Address - Country:US
Practice Address - Phone:469-686-9911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76913101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional