Provider Demographics
NPI:1659063683
Name:VAUGHN, KARON (CIT)
Entity Type:Individual
Prefix:
First Name:KARON
Middle Name:
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:CIT
Other - Prefix:
Other - First Name:KARON
Other - Middle Name:
Other - Last Name:HAWTHORNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CIT
Mailing Address - Street 1:6 PRAIRIE RD
Mailing Address - Street 2:
Mailing Address - City:MANGHAM
Mailing Address - State:LA
Mailing Address - Zip Code:71259-5326
Mailing Address - Country:US
Mailing Address - Phone:318-381-9077
Mailing Address - Fax:
Practice Address - Street 1:307 HAYES ST
Practice Address - Street 2:
Practice Address - City:RAYVILLE
Practice Address - State:LA
Practice Address - Zip Code:71269-2531
Practice Address - Country:US
Practice Address - Phone:318-728-5488
Practice Address - Fax:318-728-6282
Is Sole Proprietor?:No
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)