Provider Demographics
NPI:1467781336
Name:DICAMILLO, KAREN DAVID (LSCW-C)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:DAVID
Last Name:DICAMILLO
Suffix:
Gender:F
Credentials:LSCW-C
Other - Prefix:MISS
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:DAVID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6900 GEORGIA AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20307-5001
Mailing Address - Country:US
Mailing Address - Phone:240-432-6874
Mailing Address - Fax:
Practice Address - Street 1:6900 GEORGIA AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20307-5001
Practice Address - Country:US
Practice Address - Phone:240-432-6874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-23
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500780901041C0700X
MD129631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical