Provider Demographics
NPI:1912342486
Name:CAMP PSYCHOLOGICAL LLC.
Entity Type:Organization
Organization Name:CAMP PSYCHOLOGICAL LLC.
Other - Org Name:CAMP PSYCHOLOGICAL & CONSULTING SERVICES, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMP
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-372-5251
Mailing Address - Street 1:1924 CLAIRMONT RD
Mailing Address - Street 2:200
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-3438
Mailing Address - Country:US
Mailing Address - Phone:404-372-5251
Mailing Address - Fax:
Practice Address - Street 1:1924 CLAIRMONT RD
Practice Address - Street 2:200
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-3438
Practice Address - Country:US
Practice Address - Phone:404-372-5251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-09
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003336103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty