Mary Angelyn Vaughan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7403 Issued in TN

Practice address

1975 Manila Ave
Memphis, TN 38114-1746

Phone

(662) 380-0619

NPI assigned

Jun 9, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1073962072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 MANILA AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381141746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 MANILA AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381141746",
            "telephone_number": "662-380-0619"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5583 Murray Ave Ste 208",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381190807",
            "country_code": "US",
            "telephone_number": "901-713-0741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "MARY",
        "middle_name": "ANGELYN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "TN",
            "license": "000591406",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "7403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Boone Vasquez, CRNA
• Sarah Kristine Vassar, LCSW
• Athip Vatanapradith, MD
• Aastha Vats
• Gabrielle Vaughan, COTA/L
• Raquel Vaughan, NP
• William Tyler Vaughan, MD
• Anita L. Vaughn II
• Audrey Elizabeth Vaughn I
• Contessa Clay Vaughn, CRNA

• Clinical Social Worker in Memphis, TN
• Providers in Memphis, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.