Provider Demographics
NPI:1215161039
Name:DEBORAH VAUGHAN, MA, LPC LLC
Entity type:Organization
Organization Name:DEBORAH VAUGHAN, MA, LPC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:F
Authorized Official - Last Name:JETT
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:775-225-0077
Mailing Address - Street 1:727 6TH ST
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-4502
Mailing Address - Country:US
Mailing Address - Phone:775-225-0077
Mailing Address - Fax:844-873-2628
Practice Address - Street 1:2130 N ST NW
Practice Address - Street 2:SUITE 201
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-3026
Practice Address - Country:US
Practice Address - Phone:775-225-0077
Practice Address - Fax:844-873-2628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-07
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health