Provider Demographics
NPI:1609447671
Name:VEGA, MARIA DEL CARMEN (LMSW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:DEL CARMEN
Last Name:VEGA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06706-1758
Mailing Address - Country:US
Mailing Address - Phone:203-756-8021
Mailing Address - Fax:203-597-8637
Practice Address - Street 1:1309 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06706-1758
Practice Address - Country:US
Practice Address - Phone:203-756-8021
Practice Address - Fax:203-597-8637
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT993104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker