Provider Demographics
NPI:1891867107
Name:VIGIL, YOLANDA MARY (LCSW)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:MARY
Last Name:VIGIL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:YOLANDA
Other - Middle Name:MARY
Other - Last Name:PROULX-VIGIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1923 GRANEMORE ST.
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135
Mailing Address - Country:US
Mailing Address - Phone:702-285-2513
Mailing Address - Fax:
Practice Address - Street 1:DEPT VETERANS AFFAIRS
Practice Address - Street 2:6900 N. PECOS RD.
Practice Address - City:NO. LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89086
Practice Address - Country:US
Practice Address - Phone:702-600-6552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5565-C1041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical