Provider Demographics
NPI:1457770281
Name:CAMP, STEPHANIE A (LCPC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:A
Last Name:CAMP
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4033 DEEPWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-1404
Mailing Address - Country:US
Mailing Address - Phone:410-652-1461
Mailing Address - Fax:
Practice Address - Street 1:5820 YORK RD
Practice Address - Street 2:SUITE 202
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-3610
Practice Address - Country:US
Practice Address - Phone:301-345-1022
Practice Address - Fax:301-296-6100
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC68651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical