Provider Demographics
NPI:1720743743
Name:JONES, CAMILLE DEON (LICSW)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:DEON
Last Name:JONES
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4047 LAKEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35020-6022
Mailing Address - Country:US
Mailing Address - Phone:205-830-4833
Mailing Address - Fax:
Practice Address - Street 1:1855 DATA DR STE 155
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-1237
Practice Address - Country:US
Practice Address - Phone:205-982-3586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-04
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4709C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical