Provider Demographics
NPI:1639953797
Name:VAUGHN, CASSAUNDRA (LPC)
Entity type:Individual
Prefix:
First Name:CASSAUNDRA
Middle Name:
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3076 MOON LAKE DR
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-1842
Mailing Address - Country:US
Mailing Address - Phone:248-962-8762
Mailing Address - Fax:
Practice Address - Street 1:1550 N MILFORD RD STE 101B
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-1058
Practice Address - Country:US
Practice Address - Phone:248-462-6530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-21
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401225564101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health