Provider Demographics
NPI:1114279247
Name:VARGAS, CASSANDRA LEE (MA, LPC, NCC)
Entity Type:Individual
Prefix:MS
First Name:CASSANDRA
Middle Name:LEE
Last Name:VARGAS
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:744 N CLARK ST APT 402
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-2582
Mailing Address - Country:US
Mailing Address - Phone:949-981-2975
Mailing Address - Fax:
Practice Address - Street 1:744 N CLARK ST APT 402
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-2582
Practice Address - Country:US
Practice Address - Phone:949-981-2975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-13
Last Update Date:2012-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor