MEDICARE: JORDAN VAUGHN

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	4724	NV

General Provider Information

NPI Number	:	1891219689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDAN VAUGHN

Provider Business Mailing Address
First Line	:	600 N CARRIAGE HILL DR UNIT 1085
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89138-4742
Country	:	US
Telephone Number	:	702-588-2853
Fax Number	:

Provider Business Practice Location Address
First Line	:	7121 W CRAIG RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-6001
Country	:	US
Telephone Number	:	702-588-2853
Fax Number	:

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

Provider Enumeration Date	:	08/02/2017
Last Update Date	:	05/13/2025

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Directions to “ JORDAN VAUGHN ” Practice Location

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