Provider Demographics
NPI:1417554569
Name:VAUGHT, ANNA VICTORIA (LCSW-C)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:VICTORIA
Last Name:VAUGHT
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 E EXCHANGE PKWY APT 6201
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-1751
Mailing Address - Country:US
Mailing Address - Phone:240-593-3600
Mailing Address - Fax:
Practice Address - Street 1:3128 HUDSON XING STE 1
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-6556
Practice Address - Country:US
Practice Address - Phone:240-593-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-01
Last Update Date:2021-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD202461041C0700X
TX696491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical