Provider Demographics
NPI:1255970554
Name:VAUGHN, ELAINE (LMHC)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:VAUGHN
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 SLEATER KINNEY RD SE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-2316
Mailing Address - Country:US
Mailing Address - Phone:360-890-8838
Mailing Address - Fax:360-252-6557
Practice Address - Street 1:1210 SLEATER KINNEY RD SE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-2316
Practice Address - Country:US
Practice Address - Phone:360-890-8838
Practice Address - Fax:360-252-6557
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-03
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61223981101YM0800X
WAMC61031018101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health