Kaufman, Ivan D

Kaufman, Ivan D is an individual health care provider with primary practice located at 7435 La Bolsa Dr , Dallas TX 75248-4248. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Kaufman, Ivan D can be contacted via phone (214) 359-6072.

Contact Information

Primary practice address
7435 La Bolsa Dr Dallas TX 75248-4248
Phone: (214) 359-6072
Fax: (214) 359-6072
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 26064 Texas

Profile Details

NPI number 1407886054
LBN Legal business name Kaufman, Ivan D
Credentials LCSW, MMT
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407886054 NPPES
Texas MEDICAID 1590812-01

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