Provider Demographics
NPI:1780095505
Name:KAMINSKY, RACHEL (LLMSW)
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:
Last Name:KAMINSKY
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422W 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-2404
Mailing Address - Country:US
Mailing Address - Phone:810-496-5777
Mailing Address - Fax:810-496-5798
Practice Address - Street 1:24715 RENSSELAER ST
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-1772
Practice Address - Country:US
Practice Address - Phone:734-660-4806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-14
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010960721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical