Individual provider Active NPI

Elizabeth Barnes Vaughan, LCSW

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1124208772
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
25539 Issued in TX
Practice address
14703 Eagle Vista Dr
Houston, TX 77077
Phone
(281) 249-7100
Fax
(281) 249-7365
NPI assigned
Nov 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 25539 TX Primary

Addresses

Primary practice location

14703 Eagle Vista Dr
Houston, TX 77077

Mailing address

5730 Executive Dr Ste 230
Catonsville, MD 21228-1762
Phone (281) 249-7100

Other practice location 1

6620 Main St
Houston, TX 77030-2348
Phone (713) 798-2500

Other practice location 2

6620 Main St
Houston, TX 77030-2348
Phone (713) 798-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080211000558 TX Practitioner - Clinical Social Worker 7810070075 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25539TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Care LLC CurrentSince Jun 1, 2015 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Jun 28, 2023 Accepting new patients
Baylor College of Medicine Past Accepting new patients
Baylor College of Medicine Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

825 W Kearney St
Mesquite, TX 75149
Phone (972) 288-7660

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1124208772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5730 EXECUTIVE DR STE 230",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212281762",
            "telephone_number": "281-249-7100",
            "fax_number": "281-249-7365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14703 EAGLE VISTA DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77077",
            "telephone_number": "281-249-7100",
            "fax_number": "281-249-7365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6620 Main St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302348",
            "country_code": "US",
            "telephone_number": "713-798-2500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6620 Main St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302348",
            "country_code": "US",
            "telephone_number": "713-798-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "ELIZABETH",
        "middle_name": "BARNES",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-13",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "25539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.