Provider Demographics
NPI:1659655678
Name:CAMERON, DAVID RAYMOND (LCSW)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:RAYMOND
Last Name:CAMERON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 PEARSON LN
Mailing Address - Street 2:
Mailing Address - City:BLACK MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28711-3725
Mailing Address - Country:US
Mailing Address - Phone:828-669-0189
Mailing Address - Fax:
Practice Address - Street 1:201 N RIDGEWAY AVE
Practice Address - Street 2:
Practice Address - City:BLACK MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28711-3506
Practice Address - Country:US
Practice Address - Phone:828-669-9798
Practice Address - Fax:828-544-1080
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1616C1041C0700X
NCC0046211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical