Individual provider Active NPI

Vanessa Jazmin Vargas, BA CASAC

  • Student in an Organized Health Care Education/Training Program
  • Brooklyn, NY
National Provider Identifier
1639621014
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2857 Linden Blvd
Brooklyn, NY 11208-5126
Phone
(718) 235-3100
NPI assigned
Nov 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

2857 Linden Blvd
Brooklyn, NY 11208-5126

Mailing address

13321 85TH St
Ozone Park, NY 11417-1923
Phone (347) 803-9298

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
New York Counseling for Change, LCSW, PLLC PastSince Oct 22, 2012 Accepting new patients
New York Center for Addiction Treatment Services, Inc. Past Accepting new patients

Organizations & group practices 2

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": "1477958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1639621014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13321 85TH ST",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "114171923",
            "telephone_number": "347-803-9298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2857 LINDEN BLVD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112085126",
            "telephone_number": "718-235-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "VANESSA",
        "middle_name": "JAZMIN",
        "name_prefix": "Mrs.",
        "credential": "BA CASAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-01",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.