Mary Kathleen Vaughn, M.A. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL010855 Issued in PA

Practice address

419 Waterford St
Edinboro, PA 16412-5517

Phone

(814) 734-5021

Fax

(814) 734-1433

NPI assigned

Dec 3, 2015

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 names 1

• Mary Kathleen Foessett Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1449100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1285009118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 SHAWNEE ROAD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "45805",
            "telephone_number": "419-999-2030",
            "fax_number": "419-991-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 WATERFORD ST",
            "city": "EDINBORO",
            "state": "PA",
            "postal_code": "164125517",
            "telephone_number": "814-734-5021",
            "fax_number": "814-734-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "MARY",
        "middle_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-03",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL010855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "FOESSETT",
            "middle_name": "KATHLEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Speech-Language Pathologist in Edinboro, PA
• Providers in Edinboro, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; 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.