MEDICARE: RAQUEL VEGA LPCC, LPMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225A00000X	Music Therapist	MUS.24000027	OH
2	101YP2500X	Professional Counselor	E.2606702	OH

General Provider Information

NPI Number	:	1598463507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAQUEL VEGA LPCC, LPMT

Provider Business Mailing Address
First Line	:	9541 ENDERBY DR
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44130-1634
Country	:	US
Telephone Number	:	440-666-0242
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 5466
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44101-0466
Country	:	US
Telephone Number	:	216-971-0582
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2023
Last Update Date	:	04/19/2026

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