Provider Demographics
NPI:1093534299
Name:VEGA COUNSELING LLC
Entity type:Organization
Organization Name:VEGA COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES CONLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:520-425-6664
Mailing Address - Street 1:2708 N 4TH ST STE A-6
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-1829
Mailing Address - Country:US
Mailing Address - Phone:928-250-6753
Mailing Address - Fax:
Practice Address - Street 1:2708 N 4TH ST STE A-6
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004-1829
Practice Address - Country:US
Practice Address - Phone:928-250-6753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty