MEDICARE: PSYCHE, PLLC

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	101YM0800X	Mental Health Counselor	2955	TN
2	101YP2500X	Professional Counselor	2955	TN
3	103TB0200X	Cognitive & Behavioral Psychologist	2843	TN
4	103TC0700X	Clinical Psychologist
5	103TC2200X	Clinical Child & Adolescent Psychologist	2843	TN
6	103TF0000X	Family Psychologist	2843	TN
7	103TP2701X	Group Psychotherapy Psychologist	2843	TN
8	251B00000X	Case Management Agency
9	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
10	103TC0700X	Clinical Psychologist	2843	TN

General Provider Information

NPI Number	:	1902212111
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PSYCHE, PLLC

Provider Business Mailing Address
First Line	:	4235 HILLSBORO PIKE STE 300
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-3344
Country	:	US
Telephone Number	:	615-274-8400
Fax Number	:

Provider Business Practice Location Address
First Line	:	4235 HILLSBORO PIKE STE 300
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-3344
Country	:	US
Telephone Number	:	615-274-8400
Fax Number	:

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	DR. STEPHANIE VAUGHN
Credential	:	PSY.D.
Telephone Number	:	706-618-6578

Provider Enumeration Date	:	07/08/2014
Last Update Date	:	02/20/2022

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Directions to “PSYCHE, PLLC ” Practice Location

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