Provider Demographics
NPI:1285753319
Name:VAUGHN, KARMYN B (MSW, LICSW)
Entity type:Individual
Prefix:MS
First Name:KARMYN
Middle Name:B
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2052
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:NH
Mailing Address - Zip Code:03854-2052
Mailing Address - Country:US
Mailing Address - Phone:603-502-7671
Mailing Address - Fax:
Practice Address - Street 1:4 BACK RIVER RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-4404
Practice Address - Country:US
Practice Address - Phone:603-744-1373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH16791041C0700X
MA1169341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical