Active NPI
Michael Vaughn
- Mental Health Counselor
- Tulalip, WA
National Provider Identifier
1700036399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LH00005701
- Practice address
- 6700 Totem Beach Rd
Tulalip, WA 98271-9714 - Phone
- (360) 716-4096
- NPI assigned
- Sep 19, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LH00005701 | WA | Primary |
Addresses
Primary practice location
6700 Totem Beach Rd
Tulalip, WA 98271-9714
Mailing address
6700 Totem Beach Rd
Tulalip, WA 98271-9714
Phone (360) 716-4096
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LH00005701 | Other | WA | WASHINGTON STATE DEPARTMENT OF HEALTH LICENSED MENTAL HEALTH COUNSELOR |
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
| License | State | Type | Specialty |
|---|---|---|---|
| LH00005701 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311292800000",
"number": "1700036399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6700 TOTEM BEACH RD",
"city": "TULALIP",
"state": "WA",
"postal_code": "982719714",
"telephone_number": "360-716-4096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6700 TOTEM BEACH RD",
"city": "TULALIP",
"state": "WA",
"postal_code": "982719714",
"telephone_number": "360-716-4096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAUGHN",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-19",
"last_updated": "2011-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH00005701",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH LICENSED MENTAL HEALTH COUNSELOR",
"identifier": "LH00005701",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tulalip, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.