Provider Demographics
NPI:1184884223
Name:CAMICIA, KATHRYN HODGES (PHD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:HODGES
Last Name:CAMICIA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 CONN AVE NW
Mailing Address - Street 2:SUITE 405
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-1722
Mailing Address - Country:US
Mailing Address - Phone:202-328-0800
Mailing Address - Fax:
Practice Address - Street 1:1350 CONN. AVE., N.W.
Practice Address - Street 2:SUITE 405
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036
Practice Address - Country:US
Practice Address - Phone:202-328-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-12
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC927103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC128609Medicare PIN
DC128609Medicare UPIN