NPIMap

Organization Active NPI

Raintree Clinic

  • Addiction (Substance Use Disorder) Counselor
  • Fayetteville, NC
National Provider Identifier
1124172499
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
50018 Issued in NC
Legal business name
RAINTREE CLINIC
Practice address
804 Stamper Rd
Suite 101
Fayetteville, NC 28303-4379
Phone
(910) 323-2875
Fax
(910) 323-1355
NPI assigned
Jan 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. John D.a. Vaughn, PH.D.
Title
President
Phone
(910) 323-2875

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 50018 NC Primary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X MHL-026-176 NC

Addresses

Primary practice location

804 Stamper Rd
Suite 101
Fayetteville, NC 28303-4379

Mailing address

804 Stamper Rd
Suite 101
Fayetteville, NC 28303-4379
Phone (910) 323-2875

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1124172499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 STAMPER RD",
            "address_2": "SUITE 101",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283034379",
            "telephone_number": "910-323-2875",
            "fax_number": "910-323-1355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 STAMPER RD",
            "address_2": "SUITE 101",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283034379",
            "telephone_number": "910-323-2875",
            "fax_number": "910-323-1355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAINTREE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D.A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-323-2875",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "50018",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "MHL-026-176",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.