Provider Demographics
NPI:1679549596
Name:VAUGHAN, LINDA JUDITH (PHD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:JUDITH
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LEXINGTON LN
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04856-4027
Mailing Address - Country:US
Mailing Address - Phone:207-593-9114
Mailing Address - Fax:207-593-9034
Practice Address - Street 1:27 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:ME
Practice Address - Zip Code:04843-1710
Practice Address - Country:US
Practice Address - Phone:207-236-0510
Practice Address - Fax:207-593-9034
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC2086101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health