Provider Demographics
NPI: | 1386745172 |
---|---|
Name: | KAPLAN, SCOTT (LMFT) |
Entity type: | Individual |
Prefix: | |
First Name: | SCOTT |
Middle Name: | |
Last Name: | KAPLAN |
Suffix: | |
Gender: | M |
Credentials: | LMFT |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 60 PINELAND DR STE 201 |
Mailing Address - Street 2: | |
Mailing Address - City: | NEW GLOUCESTER |
Mailing Address - State: | ME |
Mailing Address - Zip Code: | 04260-5121 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 207-688-8622 |
Mailing Address - Fax: | 207-688-8622 |
Practice Address - Street 1: | 60 PINELAND DR |
Practice Address - Street 2: | SUITE 310 |
Practice Address - City: | NEW GLOUCESTER |
Practice Address - State: | ME |
Practice Address - Zip Code: | 04260-5124 |
Practice Address - Country: | US |
Practice Address - Phone: | 207-688-8622 |
Practice Address - Fax: | 207-688-8622 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-09-26 |
Last Update Date: | 2021-02-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
ME | MF1594 | 106H00000X |
ME | MF 1594 | 106H00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
ME | 2007603 | Other | CIGNA BEHAVIORAL HEALTH |
ME | 11583591 | Other | CAQH CREDENTIALLING ID |
ME | 284440099 | Medicaid | |
ME | 100579 | Other | ANTHEM BC/BS |