MEDICARE: KAMAKAOKALANI PENNY SCOTT LPCMH, NCC, CGC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	PC-0000089	DE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	628014	OTHER	DE	MAMSI PROVIDER ID NUMBER
3	70230	OTHER	DE	UBH PROVIDER ID NUMBER

General Provider Information

NPI Number	:	1447257886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAMAKAOKALANI PENNY SCOTT LPCMH, NCC, CGC

Provider Business Mailing Address
First Line	:	509 ROUTE 530
Second Line	:	APT 374
City	:	WHITING
State	:	NJ
Zip	:	08759-3145
Country	:	US
Telephone Number	:	732-408-7035
Fax Number	:

Provider Business Practice Location Address
First Line	:	509 ROUTE 530
Second Line	:	APT 374
City	:	WHITING
State	:	NJ
Zip	:	08759-3145
Country	:	US
Telephone Number	:	732-408-7035
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	09/29/2008

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