Provider Demographics
NPI:1881851939
Name:DAVID G. KAMEN, PH.D., P.C.
Entity Type:Organization
Organization Name:DAVID G. KAMEN, PH.D., P.C.
Other - Org Name:MAGNOLIA COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:KAMEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:603-626-1042
Mailing Address - Street 1:379 N BAY ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-2222
Mailing Address - Country:US
Mailing Address - Phone:603-626-1042
Mailing Address - Fax:
Practice Address - Street 1:23 W WEBSTER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-2913
Practice Address - Country:US
Practice Address - Phone:603-626-1042
Practice Address - Fax:603-626-1044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1008103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty