Healthcare Provider Details

I. General information

NPI: 1871062497
Provider Name (Legal Business Name): ZOE VIGNOE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ZOE SIDIROPOULOS

II. Dates (important events)

Enumeration Date: 11/14/2018
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

376 E APPLE AVE
MUSKEGON MI
49442
US

IV. Provider business mailing address

376 E APPLE AVE
MUSKEGON MI
49442-3466
US

V. Phone/Fax

Practice location:
  • Phone: 231-724-1111
  • Fax:
Mailing address:
  • Phone: 231-724-3610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801100843
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801114499
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: