Provider Demographics
NPI:1720798473
Name:CAMP, JENNIFER HOPE (LCSWA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:HOPE
Last Name:CAMP
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:943 W ANDREWS AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-2516
Mailing Address - Country:US
Mailing Address - Phone:252-433-0061
Mailing Address - Fax:
Practice Address - Street 1:403 E NASH ST UNIT B
Practice Address - Street 2:
Practice Address - City:LOUISBURG
Practice Address - State:NC
Practice Address - Zip Code:27549-2461
Practice Address - Country:US
Practice Address - Phone:252-477-0008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-02
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0181371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical