Provider Demographics
NPI:1194455832
Name:VARGAS JIMENEZ, ORLANDO (LMSW)
Entity Type:Individual
Prefix:
First Name:ORLANDO
Middle Name:
Last Name:VARGAS JIMENEZ
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1149 SULLIVAN ST
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-1670
Mailing Address - Country:US
Mailing Address - Phone:607-733-7661
Mailing Address - Fax:
Practice Address - Street 1:1149 SULLIVAN ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-1670
Practice Address - Country:US
Practice Address - Phone:607-733-7661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker