Individual
ZACHARY LEE VAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3700 W SELTICE WAY, COEUR D ALENE, ID 83814-8921
(208) 620-5255
(448) 077-3998
Mailing address
PO BOX 1387, HAYDEN, ID 83835-1387
(208) 415-0299
(208) 625-2070
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LMSW-36960
ID
1041C0700X
Clinical Social Worker
Primary
LCSW-44861
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LMSW-36960
—
ID
Enumeration date
09/20/2017
Last updated
03/04/2025
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