Healthcare Provider Details

I. General information

NPI: 1669336582
Provider Name (Legal Business Name): ALEXIA S VIGLIONE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8821 MANOR LOOP APT 208
LAKEWOOD RANCH FL
34202-3817
US

IV. Provider business mailing address

8821 MANOR LOOP APT 208
LAKEWOOD RANCH FL
34202-3817
US

V. Phone/Fax

Practice location:
  • Phone: 617-315-5941
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH26987
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: