Organization
KAIN PSYCHOLOGICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA SUE KAIN PSYD (SOLE MEMBER)
(239) 398-0337
Entity
Organization
Contact information
Practice address
1415 PANTHER LN STE 223, NAPLES, FL 34109-7874
(239) 593-6112
Mailing address
2316 PINE RIDGE RD STE 334, NAPLES, FL 34109-2006
(239) 398-0337
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY7579
FL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PY7579
DEPT OF HEALTH LICENSE
FL
Enumeration date
09/07/2018
Last updated
01/12/2019
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