Active NPI
Amanda Shannon Vaught
- Clinical Psychologist
- Coatesville, PA
National Provider Identifier
1013146117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2232
- Practice address
- 1400 Blackhorse Hill Rd
Coatesville, PA 19320-2040 - Phone
- (610) 384-7711
- NPI assigned
- Jul 9, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Psychologist | 103TC0700X | 2232 | KS | Primary |
Addresses
Primary practice location
1400 Blackhorse Hill Rd
Coatesville, PA 19320-2040
Mailing address
1400 Blackhorse Hill Rd
Coatesville, PA 19320-2040
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2232 | Other | KS | PSYCHOLOGY LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2232 | KS | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518134400000",
"number": "1013146117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 BLACKHORSE HILL RD",
"city": "COATESVILLE",
"state": "PA",
"postal_code": "193202040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 BLACKHORSE HILL RD",
"city": "COATESVILLE",
"state": "PA",
"postal_code": "193202040",
"telephone_number": "610-384-7711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAUGHT",
"first_name": "AMANDA",
"middle_name": "SHANNON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-09",
"last_updated": "2018-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "KS",
"license": "2232",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSYCHOLOGY LICENSE",
"identifier": "2232",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coatesville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.