Provider Demographics
NPI:1114680238
Name:CAMILLA POWER LLC
Entity Type:Organization
Organization Name:CAMILLA POWER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CAMILLA
Authorized Official - Middle Name:POWER
Authorized Official - Last Name:DORMENT
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:202-329-8640
Mailing Address - Street 1:1555 CONNECTICUT AVE NW STE 300
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-1125
Mailing Address - Country:US
Mailing Address - Phone:202-329-8640
Mailing Address - Fax:
Practice Address - Street 1:1555 CONNECTICUT AVE NW STE 300
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1125
Practice Address - Country:US
Practice Address - Phone:202-329-8640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-15
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty