Healthcare Provider Details

I. General information

NPI: 1902212111
Provider Name (Legal Business Name): PSYCHE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2014
Last Update Date: 02/20/2022
Certification Date: 10/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4235 HILLSBORO PIKE STE 300
NASHVILLE TN
37215-3344
US

IV. Provider business mailing address

4235 HILLSBORO PIKE STE 300
NASHVILLE TN
37215-3344
US

V. Phone/Fax

Practice location:
  • Phone: 615-274-8400
  • Fax:
Mailing address:
  • Phone: 615-274-8400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2955
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2955
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number2843
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number2843
License Number StateTN
# 6
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number2843
License Number StateTN
# 7
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number2843
License Number StateTN
# 8
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 9
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 10
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2843
License Number StateTN

VIII. Authorized Official

Name: DR. STEPHANIE VAUGHN
Title or Position: OWNER/OPERATOR
Credential: PSY.D.
Phone: 706-618-6578