Provider Demographics
NPI:1790333904
Name:SPIGNER, DOMINIQUE (DSW, LCSW, NSW-C)
Entity Type:Individual
Prefix:DR
First Name:DOMINIQUE
Middle Name:
Last Name:SPIGNER
Suffix:
Gender:F
Credentials:DSW, LCSW, NSW-C
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 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
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-30
Last Update Date:2020-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59579101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health