Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelly Vaughan, LICSW

Individual provider Clinical Social Worker · NPI 1316364094

Kelly Vaughan, LICSW is a Clinical Social Worker in Seattle, Washington. Qualified in 2011, 15 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
15
Licensed in
WA
In the registry since
2014
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

2017 NE 135th Pl
Seattle, WA 98125-3336
Phone: (630) 768-2520
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence SWI.LW.61070860 (WA)

Record details

NPI number1316364094
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorYes
NPI enumeratedMarch 19, 2014
Last updated in NPPESMay 13, 2026
Certification dateMay 13, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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