Michael Shannon Vaughn, LCSW, ADC III

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

36728 Issued in TX

Practice address

6997 Crow Rd
San Antonio, TX 78263-6245

Phone

(210) 792-4603

NPI assigned

Sep 23, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

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": "1316736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1396028668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6997 CROW RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782636245",
            "telephone_number": "210-792-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6997 CROW RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782636245",
            "telephone_number": "210-792-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "MICHAEL",
        "middle_name": "SHANNON",
        "credential": "LCSW, ADC III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-23",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "15076-0899",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "36728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TCBAP",
            "identifier": "15076-0899",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "36728",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Leslie Vaughn, FNP
• Kayla Vaughn
• Kileigh Beth Vaughn
• Leilani Aurora Vaughn
• Michael Patrick Vaughn, M.D.PHD.
• Rebecca Lynn Vaughn, LCSW
• Robert Vaughn
• Taeylor Loree Vaughn, RBT
• Toyia Vaughn, CTRS
• Kay Vavrina, RD, LD

• Clinical Social Worker in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; 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.