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General NPI Number Information
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NPI Number | 1528568854
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Entity Type | Organization
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Legal Business Name | KEVIN S CAMERON, LCSW-C, LLC
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Dates
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Enumeration Date | 02/13/2018
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Last Update Date | 04/10/2018
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Provider Practice Location Address
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Address Line | 104 FORBES ST STE 205
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City | ANNAPOLIS
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State | MD
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Zip | 21401-1598
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Country | US
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Telephone | 443-833-5980
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Fax | 410-295-0606
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Provider Business Mailing Address
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Address Line | 101 EDGE KNOL LN
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City | QUEENSTOWN
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State | MD
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Zip | 21658-1341
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Country | US
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Telephone | 515-314-3400
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Fax | 410-295-0606
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Authorized Official
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Title or Position | PROVIDER
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Name | KEVIN SCOTT CAMERON
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Credential | MSW
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Telephone | 515-314-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 19607
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License Number State | MD
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