Healthcare Provider Details

I. General information

NPI: 1245142405
Provider Name (Legal Business Name): STEPHANIE VAUGHN COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5130 HICKORY POINT FRONTAGE RD STE 5
DECATUR IL
62526-9773
US

IV. Provider business mailing address

5130 HICKORY POINT FRONTAGE RD STE 5
DECATUR IL
62526-9773
US

V. Phone/Fax

Practice location:
  • Phone: 217-886-4182
  • Fax:
Mailing address:
  • Phone: 217-886-4182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE KAY VAUGHN
Title or Position: OWNER/EMPLOYER
Credential: LCPC
Phone: 217-886-4182