Provider Demographics
NPI:1467103473
Name:WISHNICK KAMINSKY, BETH D I
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:D
Last Name:WISHNICK KAMINSKY
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 OXFORD VALLEY RD STE 603A
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-7712
Mailing Address - Country:US
Mailing Address - Phone:215-337-2404
Mailing Address - Fax:
Practice Address - Street 1:325 PENN RD UNIT 126
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-1448
Practice Address - Country:US
Practice Address - Phone:610-213-3519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-11
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0251281041C0700X
PA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical