Provider Demographics
NPI:1699817049
Name:SCHULMAN, KENNETH S (LMHC)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:S
Last Name:SCHULMAN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BERKSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-1902
Mailing Address - Country:US
Mailing Address - Phone:781-581-5902
Mailing Address - Fax:
Practice Address - Street 1:30 FEDERAL ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-3869
Practice Address - Country:US
Practice Address - Phone:781-598-2390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALM3440101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health