Michelle Vaughan, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

116019 Issued in MA

Practice address

160 Walden St
Concord, MA 01742-3622

Phone

(978) 369-7611

NPI assigned

Sep 3, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Justice Resource Institute, Inc

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Concord, MA
  • NPI 1134314131
  NPD (past)

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343001600000",
    "number": "1295983385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 PLEASANT ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024722316",
            "telephone_number": "207-467-0233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 WALDEN ST",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017423622",
            "telephone_number": "978-369-7611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2012-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "116019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig C Van Keuren, PHARMD
• Wayne Van Orman, ED.D.
• Tineke Carman Vandegrift, PSY.D.
• Abigail Vargus, MS
• Patricia Vasiliadis
• Vidya Reddy,DMD
• Natalie V Vilissova, MD
• Amanda Marie Vincent, PH.D.
• Brenda Viola, P.T.
• Daniel H Vogel, M.D.

• Clinical Social Worker in Concord, MA
• Providers in Concord, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.