Raven Symone Vaught, LISW-CP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15039 Issued in SC

Practice address

1330 Taylor Street
Columbia, SC 29220-5869

Phone

(803) 272-8055

NPI assigned

Apr 16, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1650067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651968000000",
    "number": "1679216790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 SANDRIDGE RD",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295667504",
            "telephone_number": "803-272-8055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 TAYLOR STREET",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292205869",
            "telephone_number": "803-272-8055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHT",
        "first_name": "RAVEN",
        "middle_name": "SYMONE",
        "credential": "LISW-CP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-16",
        "last_updated": "2022-05-08",
        "certification_date": "2022-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "15039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Columbia",
            "affiliation": "N",
            "address_1": "1200 Saint Andrews Rd Apt 1605",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292105869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Paul Vaughn, SCAT, ATC, OPE-C
• Robert Vaughn II, PHARMD.
• Santita Vaughn
• Ulandy Marie Vaughn, PTA
• Marcus Owen Vaught, M.D.
• Cheryl Vaulx
• Meredith Vay, PT, DPT
• Cecilia G Vazquez, RN
• Daniel Frank Vazquez
• VC Charles Home Care LLC

• Clinical Social Worker in Columbia, SC
• Providers in Columbia, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2022; 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.