Organization
JENNIFER VAUGHN THERAPY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ANNE-SONG VAUGHN LMFT (OWNER)
(218) 820-6626
Entity
Organization
Contact information
Practice address
25282 HAZELWOOD DR STE 1, NISSWA, MN 56468-2976
(218) 820-7671
(218) 600-5500
Mailing address
4682 WILDERNESS CT # 103, BRAINERD, MN 56401-2834
(218) 820-6626
(218) 600-5500
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
2090
MN
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710260708
NPI INDIVIDUAL NUMBER
—
Enumeration date
02/11/2014
Last updated
05/04/2026
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