{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "DOUGLAS B VAUGHAN PHD PC",
"LastName": null,
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"MiddleName": null,
"NamePrefix": null,
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"FirstLineMailingAddress": "1524 NE DEER CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LEES SUMMIT",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "64086-5966",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "816-289-1777",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "600 SW JEFFERSON ST",
"SecondLinePracticeLocationAddress": "SUITE 206",
"PracticeLocationAddressCityName": "LEES SUMMIT",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "64063-3988",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "816-554-7705",
"PracticeLocationAddressFaxNumber": "816-554-7706",
"EnumerationDate": "07/24/2007",
"LastUpdateDate": "07/03/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VAUGHAN",
"AuthorizedOfficialFirstName": "DOUGLAS",
"AuthorizedOfficialMiddleName": "B.",
"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": "PH.D.",
"AuthorizedOfficialTelephoneNumber": "816-289-1777",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "103TC0700X",
"TaxonomyName": "Clinical Psychologist",
"LicenseNumber": "PYR0374",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}