Provider Demographics
NPI:1225158736
Name:NORVELL, CAMILLE M (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAMILLE
Middle Name:M
Last Name:NORVELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:RED HOOK
Mailing Address - State:NY
Mailing Address - Zip Code:12571-1534
Mailing Address - Country:US
Mailing Address - Phone:917-721-2014
Mailing Address - Fax:
Practice Address - Street 1:59 W MARKET ST
Practice Address - Street 2:
Practice Address - City:RED HOOK
Practice Address - State:NY
Practice Address - Zip Code:12571-1534
Practice Address - Country:US
Practice Address - Phone:917-721-2014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010233103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical