Provider Demographics
NPI:1578690517
Name:VAUGHT, SHERRYL (LCSW)
Entity Type:Individual
Prefix:
First Name:SHERRYL
Middle Name:
Last Name:VAUGHT
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 1:311 WHITTINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-3407
Mailing Address - Country:US
Mailing Address - Phone:501-623-3477
Mailing Address - Fax:501-624-7498
Practice Address - Street 1:311 WHITTINGTON AVE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-3407
Practice Address - Country:US
Practice Address - Phone:501-623-3477
Practice Address - Fax:501-624-7498
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARLCSW #C-4991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR227997719Medicaid