Provider Demographics
NPI:1083190250
Name:FEOLA, CAMILLE (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:
Last Name:FEOLA
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2135
Mailing Address - Country:US
Mailing Address - Phone:732-725-2800
Mailing Address - Fax:908-704-1790
Practice Address - Street 1:500 N BRIDGE ST
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2135
Practice Address - Country:US
Practice Address - Phone:732-725-2800
Practice Address - Fax:908-704-1790
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC061424001041C0700X
NJ37LC0038540101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0023701Medicaid
NJ7797403Medicaid
NJ0539198Medicaid