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NPI Code Detail

MEDICARE: BERYL BUSHNELL KAMINSKY LPC, CT

MEDICARE: BERYL BUSHNELL KAMINSKY LPC, CT
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
1101YM0800XMental Health Counselor20157TX

General Provider Information

NPI Number : 1659556132
Entity Type Code : Individual
Provider Name (Legal Business Name) : BERYL BUSHNELL KAMINSKY LPC, CT
Provider Business Mailing Address
First Line : 3749 WAKEFOREST ST
Second Line :
City : HOUSTON
State : TX
Zip : 77098-5511
Country : US
Telephone Number : 713-303-9021
Fax Number :
Provider Business Practice Location Address
First Line : 5959 WEST LOOP S STE 430
Second Line :
City : BELLAIRE
State : TX
Zip : 77401-2403
Country : US
Telephone Number : 713-303-9021
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2008
Last Update Date : 10/22/2008

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