Provider Demographics
NPI:1174825152
Name:BENEDICT, CAMILLE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:
Last Name:BENEDICT
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1282 SMALLWOOD DR W
Mailing Address - Street 2:SUITE 146
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-4732
Mailing Address - Country:US
Mailing Address - Phone:240-424-9578
Mailing Address - Fax:240-607-2452
Practice Address - Street 1:1282 SMALLWOOD DR W
Practice Address - Street 2:SUITE 146
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-4732
Practice Address - Country:US
Practice Address - Phone:240-424-9578
Practice Address - Fax:240-607-2452
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-24
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD132201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical