Active NPI
Thomas E Vaughn, LPC
- Professional Counselor
- Jefferson City, MO
National Provider Identifier
1881634772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2490
- Practice address
- 1432 Southwest Blvd
Jefferson City, MO 65109 - Phone
- (573) 632-5560
- Fax
- (573) 632-5875
- NPI assigned
- Jun 8, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2490 | MO | Primary |
Addresses
Primary practice location
1432 Southwest Blvd
Jefferson City, MO 65109
Mailing address
1432 Southwest Blvd
PO Box 1128
Jefferson City, MO 65109
Phone (573) 632-5560
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 495350225 | Medicaid | MO | |
| 149884 | Other | MO | BC BS |
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 |
|---|---|---|---|
| 2490 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363651200000",
"number": "1881634772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1432 SOUTHWEST BLVD",
"address_2": "PO BOX 1128",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "65109",
"telephone_number": "573-632-5560",
"fax_number": "573-632-5875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1432 SOUTHWEST BLVD",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "65109",
"telephone_number": "573-632-5560",
"fax_number": "573-632-5875"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAUGHN",
"first_name": "THOMAS",
"middle_name": "E",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-08",
"last_updated": "2013-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2490",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "495350225",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS",
"identifier": "149884",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jefferson City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.