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General NPI Number Information
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NPI Number | 1366972226
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Entity Type | Individual
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Provider Name | ANACAROLINA VAUGHN MS, MED, LMHC
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Gender | Female
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Dates
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Enumeration Date | 06/14/2017
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Last Update Date | 07/09/2020
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Provider Practice Location Address
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Address Line | 200 WAYMONT CT STE 126-10
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City | LAKE MARY
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State | FL
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Zip | 32746-3413
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Country | US
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Telephone | 321-848-1916
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Fax | 407-603-0414
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Provider Business Mailing Address
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Address Line | 200 WAYMONT CT STE 126-10
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City | LAKE MARY
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State | FL
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Zip | 32746-3413
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Country | US
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Telephone | 321-848-1916
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Fax | 407-603-0414
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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 | MH15912
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 15912
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | MH15912
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License Number State | FL
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