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Individual

ANGELA D VAUGHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1409 OLD DOMINION BLVD, BEDFORD, VA 24523-3285
(540) 586-5429
Mailing address
1409 OLD DOMINION BLVD, BEDFORD, VA 24523-3285
(540) 586-5429

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701003204
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004945441
VA
01
145102
ANTHEM BLUE SHIELD
VA
01
367190
MHN
VA
01
540843527007
HEALTHNET FEDERAL
VA
01
O84916
SENTARA
VA
Enumeration date
09/27/2006
Last updated
10/31/2023
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