Healthcare Provider Details

I. General information

NPI: 1497660542
Provider Name (Legal Business Name): KATELYNN NICOLE MARIE CAMP LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

388 CLARK DR
CIRCLEVILLE OH
43113-1872
US

IV. Provider business mailing address

388 CLARK DR
CIRCLEVILLE OH
43113-1872
US

V. Phone/Fax

Practice location:
  • Phone: 740-474-2345
  • Fax:
Mailing address:
  • Phone: 740-474-2345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberS.2310148
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: