Provider Demographics
NPI:1821190810
Name:TAFELSKI, SCOTT R (MA, LMHC)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:R
Last Name:TAFELSKI
Suffix:
Gender:M
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 N TILLOTSON AVE
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-3988
Mailing Address - Country:US
Mailing Address - Phone:765-288-1928
Mailing Address - Fax:765-741-0310
Practice Address - Street 1:1818 WENT AVE
Practice Address - Street 2:SUITE A
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-6482
Practice Address - Country:US
Practice Address - Phone:765-288-1928
Practice Address - Fax:574-254-0188
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000722A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN010680314OtherTAX I.D. NUMBER