Provider Demographics
NPI:1336176148
Name:CAMERON, DOROTHY C (LCSW, MFT)
Entity Type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:C
Last Name:CAMERON
Suffix:
Gender:F
Credentials:LCSW, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2174 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-2206
Mailing Address - Country:US
Mailing Address - Phone:860-652-0866
Mailing Address - Fax:860-657-4421
Practice Address - Street 1:2174 MAIN ST
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-2206
Practice Address - Country:US
Practice Address - Phone:860-652-0866
Practice Address - Fax:860-657-4421
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0044191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical