Joseph Vaughan, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

149007408 Issued in IL

Practice address

920 W Custer Ave
Pontiac, IL 61764-1067

Phone

(815) 844-6109

Fax

(815) 844-3561

NPI assigned

Aug 2, 2006

Last updated

Jun 27, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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 IL

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

Specialty

Clinical Social Worker

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Institute for Human Resources of Livingston County, IlGroup PAC ID 7810066511, 5 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Institute for Human Resources of Livingston County, Il

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pontiac, IL
  • NPI 1649239674
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1508873381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 768",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617640768",
            "telephone_number": "815-844-6109",
            "fax_number": "815-844-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 W CUSTER AVE",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617641067",
            "telephone_number": "815-844-6109",
            "fax_number": "815-844-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "JOSEPH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "149007408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Kathleen Trost, PTA
• Bruce E Unterman, DDS
• Valerie Valenciano
• Robert Edward Van Meter
• Danielle Vanderveen
• Kenneth Velez, MD
• Cindy Verdun
• Lisa Vinson
• Sarah E Vitzthum, LCPC
• Wal-Mart Stores, Inc. Dba Wal-Mart (Vision Center 30-1386)

• Mental Health Counselor in Pontiac, IL
• Providers in Pontiac, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.