Provider Demographics
NPI:1720130123
Name:BLOOMBERG, CAMILLE ANN (LPC, LCADC)
Entity Type:Individual
Prefix:MRS
First Name:CAMILLE
Middle Name:ANN
Last Name:BLOOMBERG
Suffix:
Gender:F
Credentials:LPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 LAWRENCEVILLE-PENN. RD.
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08648
Mailing Address - Country:US
Mailing Address - Phone:609-219-0535
Mailing Address - Fax:
Practice Address - Street 1:2999 PRINCETON PIKE STE 5
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-3261
Practice Address - Country:US
Practice Address - Phone:609-219-0519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00139500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional