Provider Demographics
NPI:1346974862
Name:ADDERTION, CAMERON (LCSWA)
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:
Last Name:ADDERTION
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9207 BAILEYWICK RD STE 203
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-1976
Mailing Address - Country:US
Mailing Address - Phone:919-467-7777
Mailing Address - Fax:
Practice Address - Street 1:9207 BAILEYWICK RD STE 203
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-1976
Practice Address - Country:US
Practice Address - Phone:919-467-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-11
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0177811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP017781OtherNORTH CAROLINA SOCIAL WORK LICENSURE BOARD