Organization Active NPI

Joseph H. Vaughn

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rockford, IL
National Provider Identifier
1851457121
Registry record updated Jul 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
JOSEPH H. VAUGHN
Practice address
4875 Manhattan Dr
Rockford, IL 61108
Phone
(815) 227-4673
Fax
(815) 227-4675
NPI assigned
Dec 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2008

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

Authorized official

Name
Dr. Joseph H. Vaughn, PH.D.
Title
Owner
Phone
(815) 227-4673

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

4875 Manhattan Dr
Rockford, IL 61108

Mailing address

4875 Manhattan Drive
Rockford, IL 61108
Phone (815) 227-4673

Other identifiers 1

IdentifierTypeStateIssuer
10121306OtherILBLUE CROSS BLUE SHIELD

Other names 1

  • New Hope Counseling Center Other name

National Provider Directory

National Provider Directory

Locations

4875 Manhattan Dr
Rockford, IL 61108
Phone (815) 227-4673

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216252800000",
    "number": "1851457121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4875 MANHATTAN DRIVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61108",
            "telephone_number": "815-227-4673",
            "fax_number": "815-227-4675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4875 MANHATTAN DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61108",
            "telephone_number": "815-227-4673",
            "fax_number": "815-227-4675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH H. VAUGHN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2008-07-17",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-227-4673",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "10121306",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Hope Counseling Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; 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.