Jennifer Anne-Song Vaughn, M.S.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

2090 Issued in MN

Practice address

617 Oak St
Brainerd, MN 56401-3610

Phone

(218) 851-5484

NPI assigned

Sep 26, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Jennifer Anne-Song Maxfield Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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 and National Provider Directory roles.

• Acquire Mental Health Clinic

  • Addiction (Substance Use Disorder) Psychologist
  • Nisswa, MN
  • NPI 1811487887

  Marriage & Family Therapist

  NPD Authorized official
• Jennifer Vaughn Therapy Services LLC

  • Community/Behavioral Health Agency
  • Nisswa, MN
  • NPI 1609290691

  Marriage & Family Therapist

  NPD Authorized official

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

{
    "created_epoch": "1316995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1710260708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4682 WILDERNESS CT # 103",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564012834",
            "telephone_number": "218-820-6626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 OAK ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013610",
            "telephone_number": "218-851-5484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25282 Hazelwood Dr Ste 1",
            "address_purpose": "LOCATION",
            "city": "Nisswa",
            "state": "MN",
            "postal_code": "564682976",
            "country_code": "US",
            "telephone_number": "218-820-7671",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "107 Doctors Park",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "MN",
            "postal_code": "563031207",
            "country_code": "US",
            "telephone_number": "218-820-7671",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4682 Wilderness Ct # 103",
            "address_purpose": "LOCATION",
            "city": "Brainerd",
            "state": "MN",
            "postal_code": "564012834",
            "country_code": "US",
            "telephone_number": "218-820-7671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "JENNIFER",
        "middle_name": "ANNE-SONG",
        "name_prefix": "Ms.",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-26",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710260708",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MAXFIELD",
            "middle_name": "ANNE-SONG",
            "prefix": "MS.",
            "credential": "M.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alexa Vanalst
• Dannia Lor Vang, PHARMD
• John Vanmoer
• Jayme Nicole Vanrisseghem, PHARMD
• Frank Vasey, MD
• David R Vavra, MD
• Tyler John Verworn, M.D.
• Vibe Chiro
• Rachel A Vopatek, APRN,CNP
• Nancy Rae Wadsten, APRN, FNP-C

• Marriage & Family Therapist in Brainerd, MN
• Providers in Brainerd, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; 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.