Provider Demographics
NPI:1588617484
Name:KAUFMAN, L. MARLENE (LCSW)
Entity Type:Individual
Prefix:
First Name:L. MARLENE
Middle Name:
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:PA
Mailing Address - Zip Code:17501-1420
Mailing Address - Country:US
Mailing Address - Phone:717-859-3908
Mailing Address - Fax:717-859-5659
Practice Address - Street 1:904 HIGH ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:PA
Practice Address - Zip Code:17501-1420
Practice Address - Country:US
Practice Address - Phone:717-859-3908
Practice Address - Fax:717-859-5659
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW009062101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA076443Medicare ID - Type Unspecified