Provider Demographics
NPI:1346928272
Name:VARGAS-RODRIGUEZ, COURTNIE (LMFT)
Entity Type:Individual
Prefix:
First Name:COURTNIE
Middle Name:
Last Name:VARGAS-RODRIGUEZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5882 NE 17TH RD
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33334-5935
Mailing Address - Country:US
Mailing Address - Phone:305-766-5153
Mailing Address - Fax:
Practice Address - Street 1:5882 NE 17TH RD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33334-5935
Practice Address - Country:US
Practice Address - Phone:305-766-5153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FLMT3730106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health