Provider Demographics
NPI:1457405078
Name:VIGORITO, MICHAEL ANTHONY (MFT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:VIGORITO
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 CONNECTICUT AVE NW
Mailing Address - Street 2:STE 134
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-2509
Mailing Address - Country:US
Mailing Address - Phone:202-417-7171
Mailing Address - Fax:888-881-0137
Practice Address - Street 1:1660 L ST NW
Practice Address - Street 2:STE 503
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5603
Practice Address - Country:US
Practice Address - Phone:619-459-1688
Practice Address - Fax:888-881-0137
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC41512106H00000X
DCMFT0000153106H00000X
MDLC5169101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional