Healthcare Provider Details

I. General information

NPI: 1700949617
Provider Name (Legal Business Name): CARRIE VARGAS PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

559 HARTFORD PIKE STE 208
DAYVILLE CT
06241-2153
US

IV. Provider business mailing address

702 COOK HILL RD
DANIELSON CT
06239-1525
US

V. Phone/Fax

Practice location:
  • Phone: 959-995-0776
  • Fax:
Mailing address:
  • Phone: 860-208-0925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2709
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: