Provider Demographics
NPI:1699439547
Name:VIGNEAULT, STEVEN MICHAEL SR
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:MICHAEL
Last Name:VIGNEAULT
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 PILGRIM RD
Mailing Address - Street 2:
Mailing Address - City:EAST LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-1313
Mailing Address - Country:US
Mailing Address - Phone:413-333-8723
Mailing Address - Fax:413-572-6840
Practice Address - Street 1:13 PILGRIM RD
Practice Address - Street 2:
Practice Address - City:EAST LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028-1313
Practice Address - Country:US
Practice Address - Phone:413-333-8723
Practice Address - Fax:413-572-6840
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-27
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty