Provider Demographics
NPI:1992330146
Name:VIGIL, HEATHER (MSCPCC, AAC, SUDP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:VIGIL
Suffix:
Gender:
Credentials:MSCPCC, AAC, SUDP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:NEWBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:217 GARDEN DR
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-2626
Mailing Address - Country:US
Mailing Address - Phone:509-386-9471
Mailing Address - Fax:
Practice Address - Street 1:222 W BIRCH ST
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-2918
Practice Address - Country:US
Practice Address - Phone:509-973-5788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-09
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA91-2183448Medicaid