Nicholas Brendan Lee Vaughn, MSW, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

S.1700957 Issued in OH

Practice address

741 Scholl Rd
Mansfield, OH 44907

Phone

(419) 756-1717

Fax

(419) 756-5832

NPI assigned

Oct 27, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1509062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1104338326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 SCHOLL RD",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071571",
            "telephone_number": "419-756-1717",
            "fax_number": "419-756-5832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 SCHOLL RD",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "44907",
            "telephone_number": "419-756-1717",
            "fax_number": "419-756-5832"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2775 State Route 39",
            "address_purpose": "LOCATION",
            "city": "Shelby",
            "state": "OH",
            "postal_code": "448759466",
            "country_code": "US",
            "telephone_number": "740-747-3322",
            "fax_number": "740-747-3504",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2775 State Route 39",
            "address_purpose": "LOCATION",
            "city": "Shelby",
            "state": "OH",
            "postal_code": "448759466",
            "country_code": "US",
            "telephone_number": "740-747-3322",
            "fax_number": "740-747-3504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "NICHOLAS",
        "middle_name": "BRENDAN LEE",
        "name_prefix": "Mr.",
        "credential": "MSW, LSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-27",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1700957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.