Provider Demographics
NPI:1467866525
Name:CLUSTER, CAMERON RUNYON (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:CAMERON
Middle Name:RUNYON
Last Name:CLUSTER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:CAMERON
Other - Middle Name:MICHELLE
Other - Last Name:RUNYON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:314 FRANKLIN AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:BERLIN
Mailing Address - State:MD
Mailing Address - Zip Code:21811
Mailing Address - Country:US
Mailing Address - Phone:410-973-2525
Mailing Address - Fax:410-973-2527
Practice Address - Street 1:314 FRANKLIN AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811
Practice Address - Country:US
Practice Address - Phone:410-973-2525
Practice Address - Fax:410-973-2527
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD200571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD119591300Medicaid
MDS118Medicare PIN
MD211833Medicare Oscar/Certification