Provider Demographics
NPI:1558907212
Name:DOMINIQUE SPIGNER, LLC
Entity Type:Organization
Organization Name:DOMINIQUE SPIGNER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMINIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPIGNER
Authorized Official - Suffix:
Authorized Official - Credentials:DSW, LCSW, NSW-C
Authorized Official - Phone:903-380-1454
Mailing Address - Street 1:PO BOX 1756
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75456-1756
Mailing Address - Country:US
Mailing Address - Phone:903-380-1454
Mailing Address - Fax:877-415-3699
Practice Address - Street 1:106 MORGAN ST STE B
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-5600
Practice Address - Country:US
Practice Address - Phone:903-380-1454
Practice Address - Fax:877-415-3699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-18
Last Update Date:2020-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty