Individual provider Active NPI

Jackeline Vargas

  • Mental Health Counselor
  • Weston, FL
National Provider Identifier
1902759749
Registry record updated Feb 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MT3659 Issued in FL
Practice address
2853 Executive Park Dr Ste 101
Weston, FL 33331-3656
Phone
(954) 800-2686
Fax
(833) 833-2414
NPI assigned
Feb 19, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MT3659 FL Primary

Addresses

Primary practice location

2853 Executive Park Dr Ste 101
Weston, FL 33331-3656

Mailing address

2853 Executive Park Dr Ste 101
Weston, FL 33331-3656
Phone (954) 800-2686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20260303000500 FL Practitioner - Marriage and Family Therapist 1850873613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marchant Halsor LLC Ellie Mental HealthGroup PAC ID 3476928185, 6 clinicians

Practice addresses (Care Compare)

2853 Executive Park Dr
Suite 102
Weston, FL 33331-3656
Phone (954) 800-2686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MT3659FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Marchant Halsor LLC Ellie Mental Health Mental Health CurrentSince Feb 23, 2026 Accepting new patients

Locations

2853 Executive Park Dr
Ste 102
Weston, FL 33331
Phone (954) 659-1208

2853 Executive Park Dr
Ste 101
Weston, FL 33331
Phone (954) 800-2686

Organizations & group practices 1

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": "1771459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771459200000",
    "number": "1902759749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2853 EXECUTIVE PARK DR STE 101",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333313656",
            "telephone_number": "954-800-2686",
            "fax_number": "833-833-2414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2853 EXECUTIVE PARK DR STE 101",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333313656",
            "telephone_number": "954-800-2686",
            "fax_number": "833-833-2414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "JACKELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-19",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MT3659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, FL

Sources for this page

Verify at the official NPI Registry.