Healthcare Provider Details

I. General information

NPI: 1922882190
Provider Name (Legal Business Name): CAMERON CRISPENS LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N GLEBE RD STE 303
ARLINGTON VA
22207-3558
US

IV. Provider business mailing address

2501 N GLEBE RD STE 303
ARLINGTON VA
22207-3558
US

V. Phone/Fax

Practice location:
  • Phone: 508-663-3852
  • Fax:
Mailing address:
  • Phone: 508-663-3852
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904020648
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: