Provider Demographics
NPI:1861623647
Name:VARGAS, EMILY ANN (LCSW)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN
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 1:316 W 47TH ST
Mailing Address - Street 2:#1FW
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-3110
Mailing Address - Country:US
Mailing Address - Phone:212-684-6334
Mailing Address - Fax:212-273-6458
Practice Address - Street 1:460 W 34TH ST
Practice Address - Street 2:YAI 4TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-2320
Practice Address - Country:US
Practice Address - Phone:646-489-3484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY076459-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical