Stefany Vaughn Mack, LPCC-S

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

175254 Issued in KY

Practice address

1411 N Race St
Glasgow, KY 42141-3474

Phone

(270) 479-8900

Fax

(877) 308-1668

NPI assigned

Dec 12, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bluegrass Professional Counseling LLCGroup PAC ID 3476815085, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bluegrass Professional Counseling, LLC

  • Professional Counselor
  • Munfordville, KY
  • NPI 1063899789
  Medicare reassignment Care Compare group NPD
• Kimberly Gambino LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Munfordville, KY
  • NPI 1417511973
  NPD (past)
• Lifeskills, Inc.

  • Community/Behavioral Health Agency
  • Bowling Green, KY
  • NPI 1669401816
  NPD (past)

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

{
    "created_epoch": "1513036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1174038293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 N RACE ST",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421413474",
            "telephone_number": "270-479-8900",
            "fax_number": "877-308-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 N RACE ST",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421413474",
            "telephone_number": "270-479-8900",
            "fax_number": "877-308-1668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN MACK",
        "first_name": "STEFANY",
        "credential": "LPCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-12",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "175254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100496490",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenden Scott Van Der Werff, MD
• Vann Healthcare Services Inc
• Vann Homecare Inc
• E P Vann, RPH
• Vascular Lab Associates
• John Paul Vaughn, PT
• Jose Orlando Vazquez-Vicente, D.O.
• Eric Todd Vessels, M.D.
• Michele Grace Vincent, APRN
• W. Craig Tyree, MD, PLC

• Professional Counselor in Glasgow, KY
• Providers in Glasgow, KY by specialty
• Professional Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.