Provider Demographics
NPI:1255686689
Name:ROBIDOUX, CAMILLE BROOKE (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:CAMILLE
Middle Name:BROOKE
Last Name:ROBIDOUX
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CAMILLE
Other - Middle Name:B
Other - Last Name:HOOKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:225 BLEDSOE RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40962-8906
Mailing Address - Country:US
Mailing Address - Phone:606-594-2989
Mailing Address - Fax:
Practice Address - Street 1:96 HIGHWAY 3444
Practice Address - Street 2:
Practice Address - City:ANNVILLE
Practice Address - State:KY
Practice Address - Zip Code:40402-8245
Practice Address - Country:US
Practice Address - Phone:502-262-2887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2585051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical