Deborah M Vaughan, LICSW
Individual provider Active NPI Clinical Social Worker · Osterville, MA
NPI 1114959624 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1114959624
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 111267 (MA)
- Practice address
- 12 Stone Horse Rd
Osterville, MA 02655-1701 - Phone
- (508) 428-2372
- NPI assigned
- Jul 7, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040824000022 | MA | Practitioner - Clinical Social Worker | 4082688254 | Practice locations: Osterville, MA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 111267 | MA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 111267 | MA | Yes |
Addresses
Primary practice location
12 Stone Horse Rd
Osterville, MA 02655-1701
Mailing address
12 Stone Horse Rd
Osterville, MA 02655-1701
Phone (508) 428-2372
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 451337 | Other | MA | TUFTS HEALTHPLAN |
| P08462 | Other | MA | BCBS PPO |
Other providers in Osterville, MA
- Margaret Sabens
- Nancy Smith
- Stephanie Marie Soares
- Synergy Medical and Aesthetics, PLLC
- Jana K Turner
- Paula Jeanne Vintro
- Caroline Elizabeth White
- Ana Jessica Zick
All providers in Osterville, MA · Clinical Social Worker in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.