Provider Demographics
NPI:1275608903
Name:VAUGHAN, DONNA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1052 GREENWOOD SPRINGS BLVD STE H
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-6896
Mailing Address - Country:US
Mailing Address - Phone:317-739-4895
Mailing Address - Fax:317-888-8403
Practice Address - Street 1:14 TRAFALGAR SQ
Practice Address - Street 2:
Practice Address - City:TRAFALGAR
Practice Address - State:IN
Practice Address - Zip Code:46181-9515
Practice Address - Country:US
Practice Address - Phone:317-739-4895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39001812A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100073590Medicaid