Healthcare Provider Details

I. General information

NPI: 1811789605
Provider Name (Legal Business Name): CAMILLE MARIE ZIONS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 MOUNTVILLE DR
LEBANON PA
17046-8066
US

IV. Provider business mailing address

264 GARDENIA LN
LEBANON PA
17042-9775
US

V. Phone/Fax

Practice location:
  • Phone: 717-462-7003
  • Fax:
Mailing address:
  • Phone: 814-547-1783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW016947
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: