1447257886 NPI number — KAMAKAOKALANI PENNY SCOTT LPCMH, NCC, CGC

Table of content: (NPI 1083089593)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447257886 NPI number — KAMAKAOKALANI PENNY SCOTT LPCMH, NCC, CGC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCOTT
Provider First Name:
KAMAKAOKALANI
Provider Middle Name:
PENNY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPCMH, NCC, CGC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCOTT
Provider Other First Name:
K.
Provider Other Middle Name:
PENNY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPCMH, NCC, CGC
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1447257886
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/29/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

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

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
509 ROUTE 530
Provider Second Line Business Practice Location Address:
APT 374
Provider Business Practice Location Address City Name:
WHITING
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08759-3145
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-408-7035
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/30/2005

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: 101YP2500X , with the licence number:  PC-0000089 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1000032331 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 628014 . This is a "MAMSI PROVIDER ID NUMBER" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 70230 . This is a "UBH PROVIDER ID NUMBER" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".




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