Provider Demographics
NPI:1962292888
Name:BOOTH, CAMILLE MICHELLE (MSW)
Entity type:Individual
Prefix:MS
First Name:CAMILLE
Middle Name:MICHELLE
Last Name:BOOTH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 E MANOR AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-1149
Mailing Address - Country:US
Mailing Address - Phone:907-617-8424
Mailing Address - Fax:
Practice Address - Street 1:SOCIAL SCIENCE BUILDING, ROOM 255E
Practice Address - Street 2:3211 PROVIDENCE DRIVE
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4614
Practice Address - Country:US
Practice Address - Phone:907-786-1795
Practice Address - Fax:907-786-1790
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No104100000XBehavioral Health & Social Service ProvidersSocial Worker