Individual provider Active NPI

Sierra Logan Vaughan, LAMFT

  • Marriage & Family Therapist
  • Kathleen, GA
National Provider Identifier
1922848779
Registry record updated Aug 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT002426 Issued in GA
Practice address
201 Club Villa CT BLDG B
Kathleen, GA 31047-5496
Phone
(478) 449-1475
NPI assigned
May 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT002426 GA Primary

Addresses

Primary practice location

201 Club Villa CT BLDG B
Kathleen, GA 31047-5496

Mailing address

133 Camelot Rd
Gray, GA 31032-3860
Phone (478) 663-8840

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

LicenseStateTypeSpecialty
AMFT000811GAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Bridge Inc Marriage & Family Therapist Past Accepting new patients
Threadstone Therapy LLC PastSince Jun 2, 2024 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1716940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786752000000",
    "number": "1922848779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 CAMELOT RD",
            "city": "GRAY",
            "state": "GA",
            "postal_code": "310323860",
            "telephone_number": "478-663-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 CLUB VILLA CT BLDG B",
            "city": "KATHLEEN",
            "state": "GA",
            "postal_code": "310475496",
            "telephone_number": "478-449-1475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "SIERRA",
        "middle_name": "LOGAN",
        "credential": "LAMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-29",
        "last_updated": "2026-08-15",
        "certification_date": "2026-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT002426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kathleen, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2026; 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.