Provider Demographics
NPI:1992316384
Name:VARGAS, YVETTE
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:
Last Name:VARGAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 WOOSTER HTS STE 125
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-7550
Mailing Address - Country:US
Mailing Address - Phone:203-947-3210
Mailing Address - Fax:
Practice Address - Street 1:83 WOOSTER HTS STE 125
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-7550
Practice Address - Country:US
Practice Address - Phone:203-947-3210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-11
Last Update Date:2023-08-10
Deactivation Date:2023-07-18
Deactivation Code:
Reactivation Date:2023-08-02
Provider Licenses
StateLicense IDTaxonomies
CT1519101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)