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Individual
MICHAEL SHANNON VAUGHN
Active
Individual
MICHAEL SHANNON VAUGHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, ADC III
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15076-0899
TX
1041C0700X
Clinical Social Worker
Primary
36728
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15076-0899
TCBAP
TX
01
—
36728
LCSW
TX
Enumeration date
09/23/2011
Last updated
06/20/2016
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