MEDICARE: SENA KAUFMAN MA, LMHC

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	101YM0800X	Mental Health Counselor	39003627A	IN

General Provider Information

NPI Number	:	1528434545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SENA KAUFMAN MA, LMHC

Provider Business Mailing Address
First Line	:	PO BOX 751
Second Line	:
City	:	NORTH WEBSTER
State	:	IN
Zip	:	46555-0751
Country	:	US
Telephone Number	:	574-834-1393
Fax Number	:	833-527-8322

Provider Business Practice Location Address
First Line	:	225 N. MAIN ST. STE 5
Second Line	:
City	:	NORTH WEBSTER
State	:	IN
Zip	:	46555-0751
Country	:	US
Telephone Number	:	574-834-1393
Fax Number	:	833-527-8322

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

Provider Enumeration Date	:	08/13/2015
Last Update Date	:	12/08/2021

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