Provider Demographics
NPI:1316386188
Name:YUSCAK, CAMILLE M
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:M
Last Name:YUSCAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 SOUTH RD
Mailing Address - Street 2:
Mailing Address - City:HOLMES
Mailing Address - State:NY
Mailing Address - Zip Code:12531-5315
Mailing Address - Country:US
Mailing Address - Phone:914-582-0279
Mailing Address - Fax:
Practice Address - Street 1:97 SOUTH RD
Practice Address - Street 2:
Practice Address - City:HOLMES
Practice Address - State:NY
Practice Address - Zip Code:12531-5315
Practice Address - Country:US
Practice Address - Phone:914-582-0279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-14
Last Update Date:2023-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052235001041C0700X
NYR-028539-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical