Provider Demographics
NPI:1003320094
Name:KAMELIA, NINA (LCSW, LCADC)
Entity Type:Individual
Prefix:MS
First Name:NINA
Middle Name:
Last Name:KAMELIA
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 LEES AVE STE 7-10
Mailing Address - Street 2:
Mailing Address - City:COLLINGSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-2070
Mailing Address - Country:US
Mailing Address - Phone:856-834-3709
Mailing Address - Fax:
Practice Address - Street 1:24 LEES AVE STE 7-10
Practice Address - Street 2:
Practice Address - City:COLLINGSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08108-2070
Practice Address - Country:US
Practice Address - Phone:856-834-3709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-29
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00295500101YA0400X
NJ11271851041S0200X
NJ44SC057677001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool