Shemya Rayshon Vaughn, CRC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2014002625 Issued in MO

Practice address

508 Pelican Cove Dr
#5
Florissant, MO 63031-8717

Phone

(517) 203-8695

NPI assigned

May 24, 2010

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

Enrolled in CA

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

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.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Professional

  Medicare reassignment NPD

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

{
    "created_epoch": "1274659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449619200000",
    "number": "1306165782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 PELICAN COVE DR",
            "address_2": "#5",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318717",
            "telephone_number": "517-203-8695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 PELICAN COVE DR",
            "address_2": "#5",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318717",
            "telephone_number": "517-203-8695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "SHEMYA",
        "middle_name": "RAYSHON",
        "name_prefix": "Dr.",
        "credential": "CRC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-24",
        "last_updated": "2015-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2014002625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Urgent Care LLC
• Gina J Usery, M.A. PLPC
• Valley Arcade LLC
• Kenneth Daniel Van Buren I, CPS
• Laticha Vaughn
• Amanda N Ventimiglia, F.N.P.
• Kathleen Cora Verbeck
• Mary Louise Veteto I
• Chase Alexander Vickery
• Christopher Vinson

• Professional Counselor in Florissant, MO
• Providers in Florissant, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.