Provider Demographics
NPI:1215166731
Name:VIGNERY, BRYAN E (LPC)
Entity type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:E
Last Name:VIGNERY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16950 S PENROSE LN
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-8125
Mailing Address - Country:US
Mailing Address - Phone:913-568-8276
Mailing Address - Fax:
Practice Address - Street 1:11261 STRANG LINE RD
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215
Practice Address - Country:US
Practice Address - Phone:913-568-8276
Practice Address - Fax:913-696-1403
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-06
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS787101YP2500X, 1041C0700X
MO2007016865101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional