1255872768 NPI number — MRS. ALLISON MARIE KAMINSKI LMHCA

Table of content: MRS. ALLISON MARIE KAMINSKI LMHCA (NPI 1255872768)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255872768 NPI number — MRS. ALLISON MARIE KAMINSKI LMHCA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAMINSKI
Provider First Name:
ALLISON
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMHCA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
AIGNER
Provider Other First Name:
ALLISON
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1255872768
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/16/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
954 EASTPORT CENTRE DRIVE
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
VALPARAISO
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46383
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
219-286-6482
Provider Business Mailing Address Fax Number:
219-286-7367

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
954 EASTPORT CENTRE DRIVE
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
VALPARAISO
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46383
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
219-286-6482
Provider Business Practice Location Address Fax Number:
219-286-7367
Provider Enumeration Date:
03/16/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  88000215A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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