Provider Demographics
NPI:1447767637
Name:VARGAS, MADELIN A (MS, LMHC, CAP)
Entity Type:Individual
Prefix:MRS
First Name:MADELIN
Middle Name:A
Last Name:VARGAS
Suffix:
Gender:F
Credentials:MS, LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10603 SW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-6903
Mailing Address - Country:US
Mailing Address - Phone:954-600-2922
Mailing Address - Fax:
Practice Address - Street 1:741 FRONT ST STE 210
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-4992
Practice Address - Country:US
Practice Address - Phone:844-244-2840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-09
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL100119101YA0400X
FL15600101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL15600OtherLICENSED MENTAL HEALTH COUNSELOR