Provider Demographics
NPI:1558853010
Name:VARGAS, JEANNE ANN (MA, BSW)
Entity Type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:ANN
Last Name:VARGAS
Suffix:
Gender:F
Credentials:MA, BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 E HUMPHREY AVE
Mailing Address - Street 2:
Mailing Address - City:ROCK FALLS
Mailing Address - State:IL
Mailing Address - Zip Code:61071-2021
Mailing Address - Country:US
Mailing Address - Phone:815-626-5853
Mailing Address - Fax:
Practice Address - Street 1:104 E 3RD ST
Practice Address - Street 2:
Practice Address - City:ROCK FALLS
Practice Address - State:IL
Practice Address - Zip Code:61071-1287
Practice Address - Country:US
Practice Address - Phone:815-716-8385
Practice Address - Fax:815-716-8960
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker