Provider Demographics
NPI:1154801934
Name:VIGUS, ELIZABETH MARIE (TLPC-MHSP)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:MARIE
Last Name:VIGUS
Suffix:
Gender:
Credentials:TLPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 UNION AVE STE 330
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-6655
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1255 S GERMANTOWN RD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-2227
Practice Address - Country:US
Practice Address - Phone:901-432-1591
Practice Address - Fax:901-432-1596
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4037101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional