Healthcare Provider Details

I. General information

NPI: 1619251238
Provider Name (Legal Business Name): SCOTT H KAMINSKY LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2011
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3152 COUNTRY CLUB LN
JEFFERSONVILLE IN
47130-7544
US

IV. Provider business mailing address

3152 COUNTRY CLUB LN
JEFFERSONVILLE IN
47130-7544
US

V. Phone/Fax

Practice location:
  • Phone: 732-644-0286
  • Fax:
Mailing address:
  • Phone: 732-644-0286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number204541
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number35002086A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number7971
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT3971
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1791
License Number StateNC
# 6
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1049
License Number StateTN
# 7
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number779
License Number StateKS
# 8
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number106827
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: