Provider Demographics
NPI:1568850642
Name:KAMINSKY, JENNIFER (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:KAMINSKY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6100 GULFPORT BLVD S APT 502
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33707-3168
Mailing Address - Country:US
Mailing Address - Phone:727-692-3254
Mailing Address - Fax:
Practice Address - Street 1:6100 GULFPORT BLVD S APT 502
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:FL
Practice Address - Zip Code:33707-3168
Practice Address - Country:US
Practice Address - Phone:727-692-3254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-25
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW73281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical