Provider Demographics
NPI:1386466928
Name:SOIGNET, MARY VICE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:VICE
Last Name:SOIGNET
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-3402
Mailing Address - Country:US
Mailing Address - Phone:985-447-5383
Mailing Address - Fax:
Practice Address - Street 1:102 E 5TH ST
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-3402
Practice Address - Country:US
Practice Address - Phone:985-447-5383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA37011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical