Provider Demographics
NPI:1285725200
Name:VIGLIANCO, KATHLEEN SABO (LPC)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:SABO
Last Name:VIGLIANCO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3366 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-4704
Mailing Address - Country:US
Mailing Address - Phone:304-797-8343
Mailing Address - Fax:304-797-8323
Practice Address - Street 1:3366 MAIN ST
Practice Address - Street 2:
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-4704
Practice Address - Country:US
Practice Address - Phone:304-797-8343
Practice Address - Fax:304-797-8323
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV205101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVWV 205OtherLICENSE, LPC