Provider Demographics
NPI:1134711088
Name:VAUGHN, LORNA ALISE (LPC)
Entity type:Individual
Prefix:
First Name:LORNA
Middle Name:ALISE
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 MACKLIND AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1403
Mailing Address - Country:US
Mailing Address - Phone:314-537-2571
Mailing Address - Fax:314-645-7802
Practice Address - Street 1:1329 MACKLIND AVE FL 2
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1403
Practice Address - Country:US
Practice Address - Phone:314-645-7800
Practice Address - Fax:314-645-7802
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017013047101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health