Dominique Lemar Vaughan, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

13138 Issued in NC

Practice address

5200 Park Rd Ste 218B
Charlotte, NC 28209-3650

Phone

(866) 700-1606

NPI assigned

Sep 5, 2017

Sex

Male

Sole proprietor

Yes

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 NC

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

Mental Health Counselor

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Integrative Wellness Solutions PLLCGroup PAC ID 8022341494, 143 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Integrative Wellness Solutions, PLLC

  dba LifeStance Health

  • Psychologist
  • Mooresville, NC
  • NPI 1447760871
  Medicare reassignment Care Compare group
• Sparc Network

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1396155834

  Professional

  NPD (past)

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

{
    "created_epoch": "1504569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1689192239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 WOCCON PATH",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271279422",
            "telephone_number": "336-671-0961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 PARK RD STE 218B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093650",
            "telephone_number": "866-700-1606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2035 Woccon Path",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271279422",
            "country_code": "US",
            "telephone_number": "336-671-0961",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8007 N Point Blvd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271063268",
            "country_code": "US",
            "telephone_number": "866-700-1606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "DOMINIQUE",
        "middle_name": "LEMAR",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "13138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Victoria Vasquez, M.S. CCC SLP
• Kelly Vass
• Elizabeth Vassilenko
• Vatogna Steward PLLC (Therapy To Inner Peace Center)
• Andrew William Vaughan, PA
• John Watt Vaughan, M.D.
• Ashley Vaughn
• Florina Vaughn, RN
• Gloria Tulani Vaughn, LCSW
• London Elizabeth Vaughn, PA

• Mental Health Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.