Provider Demographics
NPI:1336578764
Name:VARGAS-ZACHARY, JAY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JAY
Middle Name:
Last Name:VARGAS-ZACHARY
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 1:21 LYNN BATTS
Mailing Address - Street 2:SUITE 11
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-3078
Mailing Address - Country:US
Mailing Address - Phone:210-612-2141
Mailing Address - Fax:
Practice Address - Street 1:21 LYNN BATTS
Practice Address - Street 2:SUITE 11
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218-3078
Practice Address - Country:US
Practice Address - Phone:210-612-2141
Practice Address - Fax:210-829-8788
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX544671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical