Individual provider Active NPI

Wendy Vaughter, MPA,LLMSW, DP-C

  • Clinical Social Worker
  • Troy, MI
National Provider Identifier
1417419318
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6851103737 Issued in MI
Practice address
2844 Livernois Rd
Unit 1434
Troy, MI 48099
Phone
(586) 942-1430
NPI assigned
Apr 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6851103737 MI Primary

Addresses

Primary practice location

2844 Livernois Rd
Unit 1434
Troy, MI 48099

Mailing address

PO Box 1434
Troy, MI 48099-1434
Phone (833) 322-7528

Other identifiers 2

IdentifierTypeStateIssuer
1326707399MedicaidMI
1417419318MedicaidMI

Other names 1

  • Wendy Monica Vaughter Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL prominentc@zohomail.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6851103737MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Prominent Life Changes Therapy Group. P.C. CurrentSince Feb 1, 2023 Accepting new patients
Comprehensive Youth Services Inc PastSince Jun 10, 2005 Accepting new patients

Locations

15 N Walnut St
Ste 202
Mount Clemens, MI 48043

2844 Livernois Rd
Unit 1434
Troy, MI 48099
Phone (586) 942-1430

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1417419318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1434",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480991434",
            "telephone_number": "833-322-7528",
            "fax_number": "833-740-3894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2844 LIVERNOIS RD",
            "address_2": "UNIT 1434",
            "city": "TROY",
            "state": "MI",
            "postal_code": "48099",
            "telephone_number": "586-942-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHTER",
        "first_name": "WENDY",
        "credential": "MPA,LLMSW, DP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851103737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326707399",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417419318",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "prominentc@zohomail.com",
            "affiliation": "N",
            "endpointDescription": "prominentc@zohomail.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2844 Livernois Rd",
            "address_2": "Unit 1434",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "48099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "WENDY",
            "last_name": "VAUGHTER",
            "middle_name": "MONICA",
            "credential": "MPA,LLMSW,DP-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2026; 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.