Provider Demographics
NPI:1609657253
Name:VIGILANTE, CAYTE
Entity Type:Individual
Prefix:
First Name:CAYTE
Middle Name:
Last Name:VIGILANTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 566
Mailing Address - Street 2:
Mailing Address - City:EAST BANK
Mailing Address - State:WV
Mailing Address - Zip Code:25067-0566
Mailing Address - Country:US
Mailing Address - Phone:304-549-9357
Mailing Address - Fax:
Practice Address - Street 1:888 OAKWOOD RD STE 300
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25314-2071
Practice Address - Country:US
Practice Address - Phone:681-265-0999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Single Specialty