Provider Demographics
NPI:1639560436
Name:VAUGHN, DEW (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:DEW
Middle Name:
Last Name:VAUGHN
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 1:1035 CARNATION DR
Mailing Address - Street 2:CRISIS CENTER
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-1001
Mailing Address - Country:US
Mailing Address - Phone:240-777-4000
Mailing Address - Fax:
Practice Address - Street 1:1301 PICCARD DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4320
Practice Address - Country:US
Practice Address - Phone:240-777-4546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-16
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD063171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD06317OtherDEPT. OF HEALTH AND MENTAL HYGIENE