Provider Demographics
NPI:1285687426
Name:VAUGHAN-BRIGGS, CELESTE O (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CELESTE
Middle Name:O
Last Name:VAUGHAN-BRIGGS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 S 11TH ST
Mailing Address - Street 2:BODINE CENTER FOR CANCER TREATMENT
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4824
Mailing Address - Country:US
Mailing Address - Phone:215-955-6702
Mailing Address - Fax:215-955-5331
Practice Address - Street 1:111 S 11TH ST
Practice Address - Street 2:BODINE CENTER FOR CANCER TREATMENT
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4824
Practice Address - Country:US
Practice Address - Phone:215-955-6702
Practice Address - Fax:215-955-5331
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0149011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA136668Medicare PIN