Provider Demographics
NPI:1619268943
Name:VARGAS, VERONICA JULIA (LCSW)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:JULIA
Last Name:VARGAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9201 BRODIE LN UNIT 2302
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-6276
Mailing Address - Country:US
Mailing Address - Phone:512-940-3967
Mailing Address - Fax:
Practice Address - Street 1:9201 BRODIE LN UNIT 2302
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-6276
Practice Address - Country:US
Practice Address - Phone:512-940-3967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-20
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53927104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial Worker