Healthcare Provider Details

I. General information

NPI: 1811806805
Provider Name (Legal Business Name): ARIC VAUGHN LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17111 G DR N
MARSHALL MI
49068-9621
US

IV. Provider business mailing address

17111 G DR N
MARSHALL MI
49068-9621
US

V. Phone/Fax

Practice location:
  • Phone: 269-781-5141
  • Fax:
Mailing address:
  • Phone: 269-789-2461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: