Provider Demographics
NPI:1255860839
Name:KAMINSKI, TINA (MA, MSW, LISW-CP)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:KAMINSKI
Suffix:
Gender:F
Credentials:MA, MSW, LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 SIGMA DR STE 300
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29486-7722
Mailing Address - Country:US
Mailing Address - Phone:843-576-1450
Mailing Address - Fax:
Practice Address - Street 1:201 SIGMA DR STE 300
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29486-7722
Practice Address - Country:US
Practice Address - Phone:609-933-4384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-07
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053620001041C0700X
SC129021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical