Ebony Samara Giddins Vaughan, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12666 Issued in MD

Practice address

9199 Reisterstown Rd Ste 204B
Owings Mills, MD 21117-4593

Phone

(410) 382-4536

Fax

(410) 655-1329

NPI assigned

May 14, 2008

Last updated

Jul 29, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nexus Wellness GroupGroup PAC ID 3678951068, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nexus Wellness Group

  • Clinical Social Worker
  • Owings Mills, MD
  • NPI 1033877386
  Medicare reassignment Care Compare group NPD
• Nexus Wellness Group

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Owings Mills, MD
  • NPI 1427986181
  NPD

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1871760397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3839 JANBROOK RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211332705",
            "telephone_number": "410-382-4536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9199 REISTERSTOWN RD STE 204B",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174593",
            "telephone_number": "410-382-4536",
            "fax_number": "410-655-1329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIDDINS VAUGHAN",
        "first_name": "EBONY",
        "middle_name": "SAMARA",
        "name_prefix": "Mrs.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-14",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "12666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elena D. Ghiaur, MD
• Kimika Gholson
• Giant of Maryland LLC (Giant Pharmacy 165)
• Giant of Maryland LLC (Giant Pharmacy)
• Ann Wanjiru Gichuki
• Gifts LLC (Gifts)
• Brandon Gilchrist
• Jamie Gillespie
• Rachel Gillotti Lorice Gillotti
• Jody Ginsberg, LCSW-C

• Clinical Social Worker in Owings Mills, MD
• Providers in Owings Mills, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.