Individual provider Active NPI

Jacqueline Maria Vargas, LCSW

  • Clinical Social Worker
  • Orlando, FL
National Provider Identifier
1124756101
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
3564 Avalon Park East Blvd Ste 1
Orlando, FL 32828-7365
Phone
(863) 256-9604
NPI assigned
Aug 9, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

3564 Avalon Park East Blvd Ste 1
Orlando, FL 32828-7365

Mailing address

3564 Avalon Park East Blvd Ste 1
Orlando, FL 32828-7365
Phone (863) 256-9604

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220819001356 FL Practitioner - Clinical Social Worker 0446633762 Reassigns benefits to 2 organizations
I20240911001301 TX Practitioner - Clinical Social Worker 0446633762 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brave Health Inc.Group PAC ID 8123458981, 112 clinicians

Practice addresses (Care Compare)

6304 Yellowstone St
Orlando, FL 32807-4817
Phone (305) 902-6347

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18597FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brave Health Inc. Single Specialty CurrentSince Sep 6, 2022 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Jul 30, 2024 Accepting new patients
Brave Health Medical Group PA Single Specialty CurrentSince Sep 1, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

675 Town Square Blvd
Ste 200
Garland, TX 75040
Phone (305) 579-9538

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

Interoperability endpoints

  • Direct secure messaging: jacqueline.vargas.1@23300.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1660003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1124756101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3564 AVALON PARK EAST BLVD STE 1",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287365",
            "telephone_number": "863-256-9604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3564 AVALON PARK EAST BLVD STE 1",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287365",
            "telephone_number": "863-256-9604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "JACQUELINE",
        "middle_name": "MARIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-09",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.