MEDICARE: DR. KAREN S VAUGHN PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC1900X	Counseling Psychologist	01179	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01179	OTHER	MO	MISSOURI STATE COMMITTEE OF PSYCHOLOGISTS

General Provider Information

NPI Number	:	1255619185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN S VAUGHN PH.D.

Provider Business Mailing Address
First Line	:	5140 NE ANTIOCH RD STE A
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64119-2523
Country	:	US
Telephone Number	:	405-459-5545
Fax Number	:	405-325-1478

Provider Business Practice Location Address
First Line	:	5140 NE ANTIOCH RD STE A
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64119-2523
Country	:	US
Telephone Number	:	405-985-3838
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2011
Last Update Date	:	06/21/2023

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