Provider Demographics
NPI:1265841142
Name:VAUGHN, ANA (PCMSW, PLMHP)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:PCMSW, PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 FOLKWAYS BLVD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-5079
Mailing Address - Country:US
Mailing Address - Phone:402-805-1791
Mailing Address - Fax:
Practice Address - Street 1:5600 S 59TH ST STE 104
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-8516
Practice Address - Country:US
Practice Address - Phone:402-805-1791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10307101YM0800X
NE69371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health