Healthcare Provider Details

I. General information

NPI: 1982176640
Provider Name (Legal Business Name): KRISTIN VAUGHN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2018
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1737 KING ST STE 330
ALEXANDRIA VA
22314-2760
US

IV. Provider business mailing address

1737 KING ST STE 330
ALEXANDRIA VA
22314-2760
US

V. Phone/Fax

Practice location:
  • Phone: 703-375-9393
  • Fax:
Mailing address:
  • Phone: 703-375-9393
  • 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:
Title or Position:
Credential:
Phone: