Provider Demographics
NPI:1891900858
Name:VARGAS, ANDREA (LMHC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:VARGAS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2863 EXECUTIVE PARK DR
Mailing Address - Street 2:STE 106
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3645
Mailing Address - Country:US
Mailing Address - Phone:305-338-3537
Mailing Address - Fax:954-358-5790
Practice Address - Street 1:2863 EXECUTIVE PARK DR
Practice Address - Street 2:106
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3645
Practice Address - Country:US
Practice Address - Phone:954-358-5788
Practice Address - Fax:954-358-5790
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-13
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004126700Medicaid