Provider Demographics
NPI:1821415985
Name:CAMERON, CHARLOTTE EMILY (LMFTA)
Entity Type:Individual
Prefix:MISS
First Name:CHARLOTTE
Middle Name:EMILY
Last Name:CAMERON
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N LAUREL AVE APT 115
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-1579
Mailing Address - Country:US
Mailing Address - Phone:248-895-7859
Mailing Address - Fax:
Practice Address - Street 1:100 N LAUREL AVE APT 115
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1579
Practice Address - Country:US
Practice Address - Phone:248-895-7859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-26
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9060-A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist