Provider Demographics
NPI:1346484979
Name:VAN CAMP, SCOTT A (LMFT)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:A
Last Name:VAN CAMP
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1326 JOURNEYS END DR
Mailing Address - Street 2:
Mailing Address - City:LA CANADA
Mailing Address - State:CA
Mailing Address - Zip Code:91011-1708
Mailing Address - Country:US
Mailing Address - Phone:626-486-7374
Mailing Address - Fax:
Practice Address - Street 1:1326 JOURNEYS END DR
Practice Address - Street 2:
Practice Address - City:LA CANADA
Practice Address - State:CA
Practice Address - Zip Code:91011-1708
Practice Address - Country:US
Practice Address - Phone:626-486-7374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-27
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC47066106H00000X
TX203629106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist