Provider Demographics
NPI:1316370729
Name:CAAMANO, KRISTY (LPC, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:
Last Name:CAAMANO
Suffix:
Gender:F
Credentials:LPC, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:467 LARCH LN
Mailing Address - Street 2:
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064-9608
Mailing Address - Country:US
Mailing Address - Phone:443-315-6112
Mailing Address - Fax:
Practice Address - Street 1:467 LARCH LN
Practice Address - Street 2:
Practice Address - City:NAZARETH
Practice Address - State:PA
Practice Address - Zip Code:18064-9608
Practice Address - Country:US
Practice Address - Phone:443-315-6112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2023-07-20
Deactivation Date:2023-06-12
Deactivation Code:
Reactivation Date:2023-07-05
Provider Licenses
StateLicense IDTaxonomies
PAPC006465101YM0800X
PA1-10-7054103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health