Provider Demographics
NPI:1235486150
Name:KAMPSCHAEFER, SCOTT (LCSW)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:
Last Name:KAMPSCHAEFER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3903 PETERSON AVE APT 201
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-3929
Mailing Address - Country:US
Mailing Address - Phone:512-374-0100
Mailing Address - Fax:
Practice Address - Street 1:8500 SHOAL CREEK BLVD.
Practice Address - Street 2:170
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-7597
Practice Address - Country:US
Practice Address - Phone:512-374-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX532791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical