Provider Demographics
NPI:1225432008
Name:CAMDEN, JANE L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:L
Last Name:CAMDEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 W. SOUTHERN AVE.
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85120
Mailing Address - Country:US
Mailing Address - Phone:480-982-6867
Mailing Address - Fax:
Practice Address - Street 1:2080 W SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85120-7455
Practice Address - Country:US
Practice Address - Phone:480-982-6867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-22
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW15204172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker