MEDICARE: ANNA VIGIL LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	C12017	NM
2	104100000X	Social Worker	M10080	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790203479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA VIGIL LCSW

Provider Business Mailing Address
First Line	:	111 CADENA ST
Second Line	:
City	:	MESQUITE
State	:	NM
Zip	:	88048-9348
Country	:	US
Telephone Number	:	575-636-7117
Fax Number	:

Provider Business Practice Location Address
First Line	:	1510 S SOLANO DR STE B
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88001-4287
Country	:	US
Telephone Number	:	575-636-7117
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2017
Last Update Date	:	01/06/2026

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Directions to “ ANNA VIGIL LCSW” Practice Location

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