Provider Demographics
NPI:1801531355
Name:VIGIL-ORTEGON, VANESSA (LPC-A)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:VIGIL-ORTEGON
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5227 NEVERA LOOP
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78043-4987
Mailing Address - Country:US
Mailing Address - Phone:956-285-1972
Mailing Address - Fax:
Practice Address - Street 1:1500 PAPPAS ST
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-1701
Practice Address - Country:US
Practice Address - Phone:956-794-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87423101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health