Individual
CHARLES L VAUGHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, LADC
Contact information
Practice address
13017 E 27TH ST, TULSA, OK 74134-2403
(918) 813-3391
Mailing address
PO BOX 470866, TULSA, OK 74147-0866
(918) 813-3391
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15
OK
1041C0700X
Clinical Social Worker
Primary
2543
OK
Other
Enumeration date
05/04/2007
Last updated
04/14/2014
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