Provider Demographics
NPI:1235367491
Name:AZUERO, CAMILA RENE (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:CAMILA
Middle Name:RENE
Last Name:AZUERO
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:294 PLEASANT ST STE 102
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-2571
Mailing Address - Country:US
Mailing Address - Phone:508-443-1305
Mailing Address - Fax:888-315-9980
Practice Address - Street 1:1439 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-1106
Practice Address - Country:US
Practice Address - Phone:617-575-5661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1172981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical