Provider Demographics
NPI:1740330638
Name:ROGERS-VAUGHN, ANNETTE CARLTON (LCSW)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:CARLTON
Last Name:ROGERS-VAUGHN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 VINE CT
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2052
Mailing Address - Country:US
Mailing Address - Phone:615-383-0792
Mailing Address - Fax:615-385-1879
Practice Address - Street 1:506 FAIR ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-2708
Practice Address - Country:US
Practice Address - Phone:615-790-1539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN46451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical