KELLY VAUGHAN (NPI# 1316364094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316364094 |
| Entity Type | Individual |
| Full Name | KELLY VAUGHAN |
| Credential | LCSW |
| Practice Address |
4305 N Lincoln Ave Suite O Chicago IL 60618-1711 |
| Practice Telephone | 6307682520 |
| Mailing Telephone | 6307682520 |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2014-08-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
149016408 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013383678 | Kelly J Vaughan | Case Manager/Care Coordinator | 302 3rd St Se, Loveland, CO 80537-6419 | 2015-08-18 |
| 1255655569 | Kelly J Vaughan | Dietitian, Registered | 301 N Herman St, Box Cc, Goldsboro, NC 27530-2973 | 2010-03-16 |
| Street Address |
4305 N LINCOLN AVE SUITE O |
| City | CHICAGO |
| State | IL |
| Zip Code | 60618-1711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215920608 | Phyllis Sydnie Gould | Social Worker | 4305 N Lincoln Ave, Suite N, Chicago, IL 60618-1711 | 2005-08-31 |
| 1134731458 | Susan Ae Chan | Counselor | 4305 N Lincoln Ave, Chicago, IL 60618-1807 | 2020-08-18 |
| 1346717345 | Papa Ndomu Adams | Counselor | 4305 N Lincoln Ave, Chicago, IL 60618-1807 | 2018-10-28 |
| 1356817522 | Parkside Therapy | Social Worker | 4305 N Lincoln Ave, Chicago, IL 60618-1807 | 2018-10-16 |
| 1013457951 | Embrace The Center for Emotional Wellbeing LLC | Psychologist | 4305 N Lincoln Ave, Ste M, Chicago, IL 60618-1807 | 2017-02-25 |
| 1316397979 | Catalyst Clinical Group, Inc | Social Worker | 4305 N Lincoln Ave, Suite M, Chicago, IL 60618-1711 | 2016-06-14 |
| 1023475886 | Annaliese Rosamunde Spalink | Social Worker | 4305 N Lincoln Ave, Suite M, Chicago, IL 60618-1711 | 2016-01-25 |
| 1639562192 | Jessica Albright | Counselor | 4305 N Lincoln Ave, Chicago, IL 60618-1711 | 2015-03-09 |
| 1407265143 | Creative Health Counseling, LLC | Counselor | 4305 N Lincoln Ave, Suite M, Chicago, IL 60618-1711 | 2014-08-06 |
| 1265848253 | Diane Pelegris | Social Worker | 4305 N Lincoln Ave, Suite K, Chicago, IL 60618-1711 | 2014-07-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134741622 | Cvs Aoc Services, L.L.C. | Optometrist | 4051 North Lincoln, Store 8751, Chicago, IL 60618 | 2020-05-07 |
| 1699317404 | Joseph Thank Harmon | Registered Nurse | 5645 W Addison, Chicago, IL 60618 | 2019-10-14 |
| 1760952626 | Prep Performance Center, LLC | Clinic/Center | 4022 N Rockwell Street, Chicago, IL 60618 | 2018-12-04 |
| 1528540986 | Ruby Erdmann | Dietitian, Registered | 3126 N Kimball Ave. #3w, Chicago, IL 60618 | 2018-09-02 |
| 1962997064 | Living Roots Psychotherapy, LLC | Clinic/Center | 4310 N Spaulding Ave, Chicago, IL 60618 | 2018-06-30 |
| 1962920116 | Alif Muhammad | Counselor | 3819 W Cornelia Ave #2, Chicago, IL 60618 | 2017-09-07 |
| 1417471178 | Daniel Lee Mcmillan | Counselor | 3433 N. Ridgeway Ave, Apt G, Chicago, IL 60618 | 2017-08-03 |
| 1508380486 | Callie Weinberg | Social Worker | 2945 N Damen Ave, 1s, Chicago, IL 60618 | 2017-08-01 |
| 1275062697 | Melissa Ann Prest | Dietitian, Registered | 3258 W Warner Ave, Apt 2, Chicago, IL 60618 | 2017-06-08 |
| 1871951038 | Bionic Prosthetics and Orthotics Group LLC | Prosthetic/Orthotic Supplier | 4315 N. Lincoln Avenue, Chicago, IL 60618 | 2016-02-03 |
| Find all providers in zip 60618 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295336022 | Web Healing Collective Pllc | Social Worker | 6207 N Springfield Ave, Chicago, IL 60659-1015 | 2020-11-06 |
| 1881295186 | Belva Marie Dibert | Social Worker | 6330 S Ingleside Ave Apt 3, Chicago, IL 60637-5784 | 2020-11-03 |
| 1861092835 | Lauren Less | Social Worker | 111 East Pearson St, Chicago, IL 60611 | 2020-10-29 |
| 1164022422 | Brittany Lauren Gatchell | Social Worker | 7448 N Damen Ave Apt 3n, Chicago, IL 60645-2258 | 2020-10-27 |
| 1467052803 | Seri Elaine Porter | Social Worker | 4258 N Greenview Ave Apt 2d, Chicago, IL 60613-1173 | 2020-10-26 |
| 1255930707 | Emily Ehrens | Social Worker | 303 W Institute Pl Ste 300, Chicago, IL 60610-3080 | 2020-10-25 |
| 1316546955 | Yesenia Maldonado | Social Worker | 3922 N Sayre Ave, Chicago, IL 60634-2329 | 2020-10-24 |
| 1144829201 | Andrea Hohf, Mscd, Lcsw | Social Worker | 564 W Randolph St Ste 248, Chicago, IL 60661-2218 | 2020-10-20 |
| 1215536693 | Miracleworks Therapy & Consulting LLC | Social Worker | 2138 S Indiana Ave, Chicago, IL 60616-4930 | 2020-10-18 |
| 1104425552 | Fifth Star Collective, LLC | Social Worker | 2711 N Lawndale Ave Unit 2, Chicago, IL 60647-1127 | 2020-10-17 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.