Active NPI
Timothy Vaughn, LPC
- Professional Counselor
- Martinsburg, WV
National Provider Identifier
1760630743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC1900
- Practice address
- 312 W King St
Martinsburg, WV 25401-3202 - Phone
- (304) 886-8975
- NPI assigned
- Sep 3, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701007378 | VA | |
| Professional Counselor | 101YP2500X | LPC1900 | WV | Primary |
Addresses
Primary practice location
312 W King St
Martinsburg, WV 25401-3202
Mailing address
908 Hallmark Dr
Martinsburg, WV 25403-2212
Phone (304) 886-8975
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 |
|---|---|---|---|
| 0701007378 | VA | MD | Professional Counselor |
| LPC1900 | WV | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558310400000",
"number": "1760630743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "908 HALLMARK DR",
"city": "MARTINSBURG",
"state": "WV",
"postal_code": "254032212",
"telephone_number": "304-886-8975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 W KING ST",
"city": "MARTINSBURG",
"state": "WV",
"postal_code": "254013202",
"telephone_number": "304-886-8975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAUGHN",
"first_name": "TIMOTHY",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-03",
"last_updated": "2019-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701007378",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WV",
"license": "LPC1900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinsburg, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.