Provider Demographics
NPI:1467463166
Name:VAUGHN, TERRI L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:TERRI
Middle Name:L
Last Name:VAUGHN
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 1:200 W PARKWAY AVE
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-3026
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 W PARKWAY AVE
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-3026
Practice Address - Country:US
Practice Address - Phone:336-707-2522
Practice Address - Fax:336-887-4596
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC004390101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1380KOtherBLUECROSS BLUESHIELD
NC189257OtherMEDCOST
NC6002992Medicaid