Mark William Vaughn, CRM

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

T-23-3290 Issued in OR

Practice address

23 NW Greenwood Ave
Bend, OR 97703-2078

Phone

(541) 383-4293

NPI assigned

Aug 2, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• All Care Treatment Center

  • Community/Behavioral Health Agency
  • Bend, OR
  • NPI 1679427553
  NPD (past)
• Pfeifer & Associates

  • Community/Behavioral Health Agency
  • Bend, OR
  • NPI 1396877908
  NPD (past)

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

{
    "created_epoch": "1690934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1972285682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1337 SW BOARDWALK LN",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023788",
            "telephone_number": "541-630-2458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 NW GREENWOOD AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977032078",
            "telephone_number": "541-383-4293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "credential": "CRM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-02",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "23-CRM-2206",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "T-23-3290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blake Harrison Vanmeter, MD
• Kirsten Vantzelfden, CRM
• Elena Vargas
• Vanessa Kathleen Vargas, RD
• Devon Noelle Varner, RN
• Sandy Vaughn
• Brooke C Veer-Sundermeier, APRN-DNP
• Shanelle Vega
• Maria Veliz
• Mason Lee Velletta

• Addiction (Substance Use Disorder) Counselor in Bend, OR
• Providers in Bend, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.