Provider Demographics
NPI:1346798055
Name:VARGAS, ADRIANA (LMHC)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:VARGAS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 W 125TH ST
Mailing Address - Street 2:11TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-4516
Mailing Address - Country:US
Mailing Address - Phone:212-864-4128
Mailing Address - Fax:212-662-9193
Practice Address - Street 1:55 W 125TH ST
Practice Address - Street 2:11TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-4516
Practice Address - Country:US
Practice Address - Phone:212-864-4128
Practice Address - Fax:212-662-9193
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-12
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
NY0842643101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)