Provider Demographics
NPI:1780884718
Name:KASKOWITZ, MIRIAM (LCSW AAMFT)
Entity type:Individual
Prefix:MS
First Name:MIRIAM
Middle Name:
Last Name:KASKOWITZ
Suffix:
Gender:F
Credentials:LCSW AAMFT
Other - Prefix:
Other - First Name:MIMI
Other - Middle Name:
Other - Last Name:KASKOWITZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10950 SCHUETZ RD
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146
Mailing Address - Country:US
Mailing Address - Phone:314-812-9369
Mailing Address - Fax:314-812-9398
Practice Address - Street 1:10950 SCHUETZ RD
Practice Address - Street 2:
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146
Practice Address - Country:US
Practice Address - Phone:314-812-9369
Practice Address - Fax:314-812-9398
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000819LCSW1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical