Provider Demographics
NPI:1013704212
Name:VAUGHAN, JENNIFER (LPC, NCC)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:VAUGHAN
Suffix:
Gender:
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 SHOALS LN
Mailing Address - Street 2:
Mailing Address - City:CLARKESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30523-5730
Mailing Address - Country:US
Mailing Address - Phone:678-427-7970
Mailing Address - Fax:
Practice Address - Street 1:311 SHOALS LN
Practice Address - Street 2:
Practice Address - City:CLARKESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30523-5730
Practice Address - Country:US
Practice Address - Phone:678-427-7970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003250101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional