Healthcare Provider Details

I. General information

NPI: 1487119368
Provider Name (Legal Business Name): CAMREY K OCZKOWSKI LGPC, ATR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2019
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3919 BLENHEIM BLVD STE 83B
FAIRFAX VA
22030-2430
US

IV. Provider business mailing address

1311 HARTNESS DR
GREENVILLE SC
29615-5489
US

V. Phone/Fax

Practice location:
  • Phone: 703-539-2392
  • Fax: 202-659-2291
Mailing address:
  • Phone: 864-386-9318
  • Fax: 202-659-2291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPRC15415
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number18-070
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701012929
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11306
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: