Provider Demographics
NPI:1093322489
Name:VARGA, KATHRYN (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:
Last Name:VARGA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:471 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:APALACHIN
Mailing Address - State:NY
Mailing Address - Zip Code:13732-2501
Mailing Address - Country:US
Mailing Address - Phone:607-786-2024
Mailing Address - Fax:
Practice Address - Street 1:471 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:APALACHIN
Practice Address - State:NY
Practice Address - Zip Code:13732-2501
Practice Address - Country:US
Practice Address - Phone:607-786-2024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-29
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1104171041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool