Healthcare Provider Details

I. General information

NPI: 1255229803
Provider Name (Legal Business Name): CELINE VIGNEAULT MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2025
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4920 LORING DR
WEST PALM BEACH FL
33417-8052
US

IV. Provider business mailing address

4847 DAVID S MACK DR
WEST PALM BEACH FL
33417-8023
US

V. Phone/Fax

Practice location:
  • Phone: 561-209-6123
  • Fax:
Mailing address:
  • Phone: 561-206-6123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW18565
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: