Individual provider Active NPI

Jonathan Floyd Vaughan-Fier, MSW, LICSW

  • Clinical Social Worker
  • Saint Paul, MN
National Provider Identifier
1477797876
Registry record updated Apr 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
16028 Issued in MN
Practice address
241 Cleveland Ave S
Saint Paul, MN 55105-1208
Phone
(651) 214-0181
NPI assigned
Apr 29, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2009

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 16028 MN Primary

Addresses

Primary practice location

241 Cleveland Ave S
Saint Paul, MN 55105-1208

Mailing address

1426 Juliet Ave
Saint Paul, MN 55105-2565
Phone (651) 224-4349

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
16028MNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240963200000",
    "number": "1477797876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 JULIET AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052565",
            "telephone_number": "651-224-4349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 CLEVELAND AVE S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551051208",
            "telephone_number": "651-214-0181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHAN-FIER",
        "first_name": "JONATHAN",
        "middle_name": "FLOYD",
        "name_prefix": "Mr.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-29",
        "last_updated": "2009-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "16028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2009; 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.