MEDICARE: DR. MARSHA J. VAUGHN PH.D., LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	166-000564	IL

General Provider Information

NPI Number	:	1437365046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARSHA J. VAUGHN PH.D., LMFT

Provider Business Mailing Address
First Line	:	1501 W WOODS DR APT 720
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-2091
Country	:	US
Telephone Number	:	847-691-0940
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 W WOODS DR APT 720
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-2091
Country	:	US
Telephone Number	:	847-691-0940
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	02/21/2023

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