Individual provider Active NPI

Nadine Vaughan, PH.D.

  • Clinical Psychologist
  • Tavares, FL
National Provider Identifier
1093756637
Registry record updated Feb 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY6663 Issued in FL
Practice address
101 E Maud St
Tavares, FL 32778-3249
Phone
(352) 253-9348
Fax
(352) 253-9351
NPI assigned
Jun 8, 2006
Last updated
Feb 18, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY6663 FL Primary
Clinical Psychologist 103TC0700X PY13578 CA

Addresses

Primary practice location

101 E Maud St
Tavares, FL 32778-3249

Mailing address

101 E Maud St
Tavares, FL 32778-3249
Phone (352) 253-9348

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY13578CAMDClinical Psychologist
PY6663FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Neuropsychology & Counseling Services PA PastSince Mar 7, 2008 Accepting new patients
Counseling & Development Center Inc PastSince Feb 20, 2013 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234915200000",
    "number": "1093756637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E MAUD ST",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327783249",
            "telephone_number": "352-253-9348",
            "fax_number": "352-253-9351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E MAUD ST",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327783249",
            "telephone_number": "352-253-9348",
            "fax_number": "352-253-9351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "NADINE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2009-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY6663",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PY13578",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.