Provider Demographics
NPI:1255619185
Name:VAUGHN, KAREN S (PHD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:S
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:S
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:5140 NE ANTIOCH RD STE A
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64119-2523
Mailing Address - Country:US
Mailing Address - Phone:405-459-5545
Mailing Address - Fax:405-325-1478
Practice Address - Street 1:5140 NE ANTIOCH RD STE A
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64119-2523
Practice Address - Country:US
Practice Address - Phone:405-985-3838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-26
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01179103TC1900X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO01179OtherMISSOURI STATE COMMITTEE OF PSYCHOLOGISTS
MO01179OtherMISSOURI STATE COMMITTEE OF PSYCHOLOGISTS