Kenneth A Vaughn Jr., RC CADC I CRM QMHA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

08-06-73 Issued in OR

Practice address

3325 Harold Dr NE
Salem, OR 97305-1339

Phone

(503) 363-2021

Fax

(503) 363-4820

NPI assigned

Dec 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353024000000",
    "number": "1164582896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3325 HAROLD DR NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051339",
            "telephone_number": "503-363-2021",
            "fax_number": "503-363-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 HAROLD DR NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051339",
            "telephone_number": "503-363-2021",
            "fax_number": "503-363-4820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "KENNETH",
        "middle_name": "A",
        "name_suffix": "Jr.",
        "credential": "RC  CADC I CRM QMHA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2012-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "08-06-73",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "RC00052879",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OR",
            "license": "QMHA",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Grizelda Vargas
• John M Vargo, D O
• Rachelle Ann Vargo
• Joanna Louise Varner, RN
• Amy Lynn Vaughn, CRM
• Victoria Vaughn, PTA
• Margherita Zaheera Vaulte, PSY.D.
• Martina Georgette Vawser, CSFA
• Evangelina Vazquez-Ortega, CCC-SLP
• Brandy Vazquez, LPN

• Addiction (Substance Use Disorder) Counselor in Salem, OR
• Providers in Salem, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2012; 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.