Healthcare Provider Details

I. General information

NPI: 1730877176
Provider Name (Legal Business Name): HANNA SIVIA VAUGHN LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2023
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 MAIN ST
NORTHAMPTON MA
01060-3188
US

IV. Provider business mailing address

73 W PELHAM RD
SHUTESBURY MA
01072-9785
US

V. Phone/Fax

Practice location:
  • Phone: 802-319-9329
  • Fax:
Mailing address:
  • Phone: 413-336-8694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number228169
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: