Provider Demographics
NPI:1487808978
Name:VARGAS, RAMONA (LCSW)
Entity type:Individual
Prefix:MS
First Name:RAMONA
Middle Name:
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 1:21 FORT WASHINGTON AVE
Mailing Address - Street 2:#4E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-4637
Mailing Address - Country:US
Mailing Address - Phone:917-974-0660
Mailing Address - Fax:
Practice Address - Street 1:21 FORT WASHINGTON AVE
Practice Address - Street 2:#4E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-4637
Practice Address - Country:US
Practice Address - Phone:917-974-0660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP0569461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP056946Medicaid