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Individual

DR. VAUGHN A HARDESTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
32 PLEASANT ST, PORTLAND, ME 04101-3912
(207) 828-5309
Mailing address
32 PLEASANT ST, PORTLAND, ME 04101-3912

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
PS 204
ME
103TB0200X
Cognitive & Behavioral Psychologist
PS 204
ME
103TC0700X
Clinical Psychologist
PS 204
ME
103TC2200X
Clinical Child & Adolescent Psychologist
PS 204
ME
103TF0000X
Family Psychologist
PS 204
ME
103TM1800X
Intellectual & Developmental Disabilities Psychologist
PS 204
ME
103TS0200X
School Psychologist
Primary
PS 204
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
003499
BLUE CROSS BLUE SHIELD
01
2068373
CIGNA
01
7041539
AETNA
01
A014080
VALUE OPTIONS
Enumeration date
12/26/2006
Last updated
09/11/2025
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