Provider Demographics
NPI:1356698435
Name:VAUGHAN, EMILY A (LPCC, CADC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:A
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:LPCC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 DOVE RUN RD
Mailing Address - Street 2:STE 106
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-3588
Mailing Address - Country:US
Mailing Address - Phone:859-317-1032
Mailing Address - Fax:
Practice Address - Street 1:1025 DOVE RUN RD
Practice Address - Street 2:STE. 106
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-3588
Practice Address - Country:US
Practice Address - Phone:859-317-1032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1673101YM0800X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)