Individual provider Active NPI

Pamela M Vaught, ED.D.

  • Marriage & Family Therapist
  • Grand Rapids, MI
National Provider Identifier
1154318806
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4101006334 Issued in MI
Practice address
1256 Walker Ave NW
Grand Rapids, MI 49504
Phone
(616) 235-2910
Fax
(616) 235-1436
NPI assigned
Sep 28, 2005
Sex
Female
Sole proprietor
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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 07010001257 VA
Professional Counselor 101YP2500X 6401010056 MI
Marriage & Family Therapist 106H00000X 0717000110 VA
Marriage & Family Therapist 106H00000X 4101006334 MI Primary

Addresses

Primary practice location

1256 Walker Ave NW
Grand Rapids, MI 49504

Mailing address

7240 Riverdell Farms Rd
Lowell, MI 49331
Phone (616) 897-3059

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6401010056MIMDProfessional Counselor
07010001257VAMDProfessional Counselor
4101006334MIMDMarriage & Family Therapist
0717000110VAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1127865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1154318806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7240 RIVERDELL FARMS RD",
            "city": "LOWELL",
            "state": "MI",
            "postal_code": "49331",
            "telephone_number": "616-897-3059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1256 WALKER AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49504",
            "telephone_number": "616-235-2910",
            "fax_number": "616-235-1436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHT",
        "first_name": "PAMELA",
        "middle_name": "M",
        "credential": "ED.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-28",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "07010001257",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401010056",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717000110",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101006334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

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.