DR. MARK P. VIGEN (NPI# 1457329120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457329120 |
| Entity Type | Individual |
| Full Name | DR. MARK P. VIGEN |
| Credential | PH.D. |
| Practice Address |
3341 Youree Dr Ste 20a Shreveport LA 71105-2149 |
| Practice Telephone | 3184252000 |
| Practice Fax Number | 3184242601 |
| Mailing Telephone | 3184252000 |
| Mailing Fax Number | 3184242601 |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2020-01-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TF0200X |
Psychologist Specialization: Forensic |
280 | LA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | BLUE CROSS/BLUE SHIELD | 20559 | 01 |
| LA | VALUE OPTIONS | 009755 | 01 |
| Street Address |
3341 YOUREE DR STE 20A |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71105-2149 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386612042 | Ronald A. Goebel | Clinical Neuropsychologist | 3341 Youree Dr Ste 20a, Shreveport, LA 71105-2149 | 2006-03-09 |
| 1154951986 | M. Todd Lobrano, Psychologist, L.L.C. | Psychologist | 3341 Youree Dr Ste 20a, Shreveport, LA 71105-2149 | 2020-01-21 |
| 1881224608 | Shelley Visconte, Psychologist, L.L.C. | Psychologist | 3341 Youree Dr Ste 20a, Shreveport, LA 71105-2149 | 2020-01-21 |
| 1316577141 | Jennifer L Russell, Psychologist, LLC | Psychologist | 3341 Youree Dr Ste 20a, Shreveport, LA 71105-2149 | 2020-01-21 |
| 1831739820 | Psychology Associates of N.w. Louisiana, L.L.C. | Psychologist | 3341 Youree Dr Ste 20a, Shreveport, LA 71105-2149 | 2020-01-08 |
| 1942757430 | Keshia Ashley Jabbar | Counselor | 3341 Youree Dr Ste 20a, Shreveport, LA 71105-2149 | 2016-09-01 |
| 1750761847 | Michael Todd Lobrano | Psychologist | 3341 Youree Dr Ste 20a, Shreveport, LA 71105-2149 | 2015-06-03 |
| 1114347846 | Jennifer Russell | Psychologist | 3341 Youree Dr Ste 20a, Shreveport, LA 71105-2149 | 2014-04-21 |
| 1235303710 | Shelley R Visconte | Counselor | 3341 Youree Dr Ste 20a, Shreveport, LA 71105-2149 | 2008-04-16 |
| 1477732188 | Ronald A Goebel & Mark P Vigen Ptr | Psychologist | 3341 Youree Dr Ste 20a, Shreveport, LA 71105-2149 | 2007-10-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699245928 | Misty Johnetta Ross | Counselor | 2942 Knight St., Bldg. 4 Suite 426, Shreveport, LA 71105 | 2018-11-29 |
| 1205301868 | Tatjhana Maury | Case Manager/Care Coordinator | 3325 Youree Drive, Shreveport, LA 71105 | 2018-10-10 |
| 1245710920 | Jefferey Douglas Adair Md | Non-Pharmacy Dispensing Site | 8860 Fern Ave., Suite 120, Shreveport, LA 71105 | 2018-08-21 |
| 1679059539 | Michael E Woolbert Dds LLC | Dentist | 7600 Fern Avenue, Building 1100, Shreveport, LA 71105 | 2018-07-13 |
| 1881195675 | Adiba Bibi | Pharmacist | 3555 Greenwood Road, Walgreens, Shreveport, LA 71105 | 2018-02-27 |
| 1740796655 | Allison Borel | Counselor | 2020 E 70th St Ste 201, Shreveport, LA 71105 | 2017-12-15 |
| 1073028148 | Valerie Wooten Barcelona | Physical Therapist | 130 Kayla Street, Shreveport, LA 71105 | 2017-12-11 |
| 1710497615 | Jimmy Carroll | Counselor | 2960 Knight St, Suite 110, Shreveport, LA 71105 | 2017-10-05 |
| 1932618444 | David Louis Bennett | Counselor | 3007 Knight St., Suite 200, Shreveport, LA 71105 | 2017-09-27 |
| 1619496452 | Shaqwana Hodge | Counselor | 2920 Knight St. Suite 110, Shreveport, LA 71105 | 2017-09-13 |
| Find all providers in zip 71105 | ||||
| Taxonomy Code | 103TF0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Forensic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760864276 | Angels Hearts LLC | Psychologist | 604 Center St, New Iberia, LA 70560-5502 | 2015-06-20 |
| 1457980203 | Jennifer Harmon | Psychologist | 1430 Tulane Ave # 8055, New Orleans, LA 70112-2632 | 2020-04-03 |
| City | SHREVEPORT |
| Zip Code | 71105 |
Please comment or provide details below to improve the information on DR. MARK P. VIGEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.