Jose Vargas, LCSW, CASAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

078403-1 Issued in NY

Practice address

14 Mill Dr
Mastic Beach, NY 11951-1803

Phone

(631) 745-8205

NPI assigned

Jun 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Southshore Counseling Mediation and Licensed Clinical Social Work Serv

  • Clinical Social Worker
  • Brookhaven, NY
  • NPI 1366684078
  Medicare reassignment NPD
• Open Hands Multi-Counseling Services

  • Clinical Social Worker
  • Mastic, NY
  • NPI 1356017057
  NPD Authorized official
• Genoa Healthcare LLC

  • Long Term Care Pharmacy
  • Brockton, MA
  • NPI 1992521512
  NPD (past)

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350950400000",
    "number": "1174727440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 MILL DR",
            "city": "MASTIC BEACH",
            "state": "NY",
            "postal_code": "119511803",
            "telephone_number": "631-745-8205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 MILL DR",
            "city": "MASTIC BEACH",
            "state": "NY",
            "postal_code": "119511803",
            "telephone_number": "631-745-8205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "JOSE",
        "credential": "LCSW, CASAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2012-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "16811",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "078403-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Ann Tanaka
• Angela R Tassa, LPN
• Adrianne Suzanne Thilman
• Stephanie Toney
• Tri-Hamlet Taxi Inc.
• Taylor Viggers, MS, CCC-SLP
• Raniesha Wilkins
• William Floyd School District
• Tamika Williams-Hood
• Anton L Williams, LPN

• Clinical Social Worker in Mastic Beach, NY
• Providers in Mastic Beach, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.