Provider Demographics
NPI:1265662837
Name:CAMERON COUNSELING SERVICES
Entity Type:Organization
Organization Name:CAMERON COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMERON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:860-338-4841
Mailing Address - Street 1:94 TAVERN CIR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-1561
Mailing Address - Country:US
Mailing Address - Phone:860-338-4841
Mailing Address - Fax:
Practice Address - Street 1:460 SMITH ST
Practice Address - Street 2:SUITE L
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-1594
Practice Address - Country:US
Practice Address - Phone:860-338-4841
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-17
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0066351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty