Provider Demographics
NPI:1841744786
Name:CAMERON, CHRISTINE (LMSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:CAMERON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5955 47TH AVE
Mailing Address - Street 2:#14C
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-5668
Mailing Address - Country:US
Mailing Address - Phone:917-224-7918
Mailing Address - Fax:
Practice Address - Street 1:5955 47TH AVE
Practice Address - Street 2:#14C
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-5668
Practice Address - Country:US
Practice Address - Phone:917-224-7918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0937801104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker