Provider Demographics
NPI:1831651264
Name:VAUGHAN, MICHELLE ELIZABETH (LPC, ATR-BC)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:ELIZABETH
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:LPC, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16480 MEADOWVIEW CT
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-8907
Mailing Address - Country:US
Mailing Address - Phone:703-771-5710
Mailing Address - Fax:
Practice Address - Street 1:16480 MEADOWVIEW CT
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-8907
Practice Address - Country:US
Practice Address - Phone:703-771-5710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008228101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional