Active NPI
Amanda Vaughan, LCSW
- Clinical Social Worker
- Greensboro, NC
National Provider Identifier
1760554158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C004291
- Practice address
- 315 E Washington St
Greensboro, NC 27401-2911 - Phone
- (336) 387-6161
- Fax
- (336) 387-9167
- NPI assigned
- Nov 14, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C004291 | NC | Primary |
Addresses
Primary practice location
315 E Washington St
Greensboro, NC 27401-2911
Mailing address
902 Bonner Dr
Jamestown, NC 27282-8948
Phone (336) 387-6161
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6003711 | Medicaid | NC |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110106000545 | NC | Practitioner - Clinical Social Worker | 7911196936 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C004291 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rha Health Services, Inc | Current | Accepting new patients | |
| Rha Health Services Inc | Current | Accepting new patients | |
| Rha Health Services Inc | Current | Accepting new patients | |
| Grounded for Peace Wellness Services, PLLC | Current | Accepting new patients |
Locations
211 Perimeter Center Pkwy NE
Ste 750
Atlanta, GA 30346
1100 Revolution Mill Dr
Ste 8
Greensboro, NC 27405
211 S Centennial St
High Point, NC 27260
Phone (336) 841-0143
Organizations & group practices 4
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Greensboro, NC
- NPI 1053887075
-
- Community/Behavioral Health Agency
- High Point, NC
- NPI 1114293271
-
- Community/Behavioral Health Agency
- Yanceyville, NC
- NPI 1629489307
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1760554158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "902 BONNER DR",
"city": "JAMESTOWN",
"state": "NC",
"postal_code": "272828948",
"telephone_number": "336-387-6161",
"fax_number": "336-387-9167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 E WASHINGTON ST",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274012911",
"telephone_number": "336-387-6161",
"fax_number": "336-387-9167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAUGHAN",
"first_name": "AMANDA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-14",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C004291",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6003711",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.