Healthcare Provider Details

I. General information

NPI: 1386745172
Provider Name (Legal Business Name): SCOTT KAPLAN LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 02/04/2021
Certification Date: 02/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 PINELAND DR SUITE 310
NEW GLOUCESTER ME
04260-5124
US

IV. Provider business mailing address

60 PINELAND DR STE 201
NEW GLOUCESTER ME
04260-5121
US

V. Phone/Fax

Practice location:
  • Phone: 207-688-8622
  • Fax: 207-688-8622
Mailing address:
  • Phone: 207-688-8622
  • Fax: 207-688-8622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMF1594
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMF 1594
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: