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General NPI Number Information
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NPI Number | 1841043858
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Entity Type | Individual
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Provider Name | KRISTINA MARIE VAUGHAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/09/2024
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 22001 SOUTHWEST FWY STE 125
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City | RICHMOND
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State | TX
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Zip | 77469-7118
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Country | US
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Telephone | 844-824-8775
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Fax | 281-648-2200
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Provider Business Mailing Address
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Address Line | 3223 S LOOP 289 SUITE 600, PRIVATE OFFICE 630
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City | LUBBOCK
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State | TX
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Zip | 79423-1337
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Country | US
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Telephone |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 65945
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.027899
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License Number State | IL
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