Provider Demographics
NPI:1538201728
Name:VARGAS, GAIL (MSW CSW BCD LCSW ACS)
Entity type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:
Last Name:VARGAS
Suffix:
Gender:F
Credentials:MSW CSW BCD LCSW ACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 PINEY STREET
Mailing Address - Street 2:
Mailing Address - City:ISLIP TERRACE
Mailing Address - State:NY
Mailing Address - Zip Code:11752
Mailing Address - Country:US
Mailing Address - Phone:631-581-3788
Mailing Address - Fax:
Practice Address - Street 1:LAWRENCE LANE
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706
Practice Address - Country:US
Practice Address - Phone:631-665-2554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical