Provider Demographics
NPI:1366263188
Name:SCALES, KAMILLAH (MS, NCC, PC-A)
Entity type:Individual
Prefix:
First Name:KAMILLAH
Middle Name:
Last Name:SCALES
Suffix:
Gender:F
Credentials:MS, NCC, PC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 COUNTRY CLUB RD STE B
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2479
Mailing Address - Country:US
Mailing Address - Phone:541-520-4852
Mailing Address - Fax:
Practice Address - Street 1:240 COUNTRY CLUB RD STE B
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2479
Practice Address - Country:US
Practice Address - Phone:541-520-4852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-23
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR9613101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional