Provider Demographics
NPI:1689311128
Name:DIAMOND, CAMILLE JAZMYNE (LCSW)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:JAZMYNE
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 ISABELLA AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07106-2029
Mailing Address - Country:US
Mailing Address - Phone:917-865-5461
Mailing Address - Fax:
Practice Address - Street 1:205 HUDSON ST FL 9
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-1810
Practice Address - Country:US
Practice Address - Phone:862-419-3935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker