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General NPI Number Information
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NPI Number | 1164048799
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Entity Type | Individual
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Provider Name | VAUGHN RUSSO SADEKNI LPC
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Gender | Male
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Dates
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Enumeration Date | 06/19/2020
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Last Update Date | 07/27/2025
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Provider Practice Location Address
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Address Line | 4154 OLD WILLIAM PENN HWY
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City | MURRYSVILLE
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State | PA
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Zip | 15668-1942
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Country | US
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Telephone | 412-295-4345
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Fax |
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Provider Business Mailing Address
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Address Line | 213 N SHENANDOAH DR
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City | LATROBE
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State | PA
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Zip | 15650-2522
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Country | US
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Telephone | 724-433-2380
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC012034
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License Number State | PA
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