Provider Demographics
NPI:1568759892
Name:VAUGHNS, DAVID M (LCSW, MA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:VAUGHNS
Suffix:
Gender:M
Credentials:LCSW, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 W 111TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-4206
Mailing Address - Country:US
Mailing Address - Phone:203-444-3594
Mailing Address - Fax:
Practice Address - Street 1:114 W 111TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-4206
Practice Address - Country:US
Practice Address - Phone:203-444-3594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-07
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist