Doctor Name: | KENNETH A VAUGHN |
NPI Number: | 1164582896 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | RC CADC I CRM QMHA |
License Number: | RC00052879 |
Business Practice Address: | 3325 Harold Dr Ne Salem, OR - 973051339 |
Business Phone Number: | 5033632021 |
Business Fax Number: | 5033634820 |
Mailing Address: | 3325 Harold Dr Ne, SALEM |
State: | OR |
Postal Code: | 973051339 |
Phone Number: | 5033632021 |
Fax Number: | 5033634820 |
NPI Enumeration Date: | 12/11/2006 |
NPI Last Update Date: | 11/16/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | RC00052879 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |