Molly Claire Vaughan, LMSW
Individual provider Active NPI Social Worker · Gravette, AR
NPI 1669244174 · NPPES record last updated Oct 27, 2023
Key facts
- NPI
- 1669244174
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 9811-M (AR)
- Practice address
- 1101 Jackson St SW
Gravette, AR 72736-9121 - Phone
- (479) 344-6714
- Fax
- (479) 344-6720
- NPI assigned
- Oct 27, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9811-M | AR | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 9811-M | AR | Yes |
Addresses
Primary practice location
1101 Jackson St SW
Gravette, AR 72736-9121
Mailing address
106 Lion Dr N
Gravette, AR 72736-8621
Phone (479) 787-8332
Other providers in Gravette, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.