| Vaughters Specialized Consultative Services Llc | |
|
211 S Center St Ste 409 Statesville NC 28677-5873 | |
| (704) 232-1470 | |
| Not Available |
| Full Name | Vaughters Specialized Consultative Services Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 211 S Center St Ste 409, Statesville, North Carolina |
| Authorized Official Name and Position | Belinda Vaughters (OWNER) |
| Authorized Official Contact | 7042321470 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vaughters Specialized Consultative Services Llc 3003 Deep Cove Dr Nw Concord NC 28027-2544 Ph: () - | Vaughters Specialized Consultative Services Llc 211 S Center St Ste 409 Statesville NC 28677-5873 Ph: (704) 232-1470 |
| NPI Number | 1851705446 |
|---|---|
| Provider Enumeration Date | 06/11/2014 |
| Last Update Date | 12/01/2020 |
| Certification Date | 12/01/2020 |
| Medicare PECOS PAC ID | 1052694890 |
|---|---|
| Medicare Enrollment ID | O20210106001712 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851705446 | NPI | - | NPPES |
| Provider Name | Bernard H Sullivan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1326282633 PECOS PAC ID: 8527201755 Enrollment ID: I20130906000642 |
| Provider Name | Nicole M Peacock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831428523 PECOS PAC ID: 8527354836 Enrollment ID: I20160913002381 |
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