MEDICARE: GAYLE CAMERON LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	0904000878	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	242669	OTHER	VA	ANTHEM

General Provider Information

NPI Number	:	1144328162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAYLE CAMERON LCSW

Provider Business Mailing Address
First Line	:	221 77TH ST
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-1918
Country	:	US
Telephone Number	:	757-343-7276
Fax Number	:	757-498-1048

Provider Business Practice Location Address
First Line	:	2940 N LYNNHAVEN RD
Second Line	:	SUITE 110
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-6949
Country	:	US
Telephone Number	:	757-343-7276
Fax Number	:	757-498-1048

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	05/31/2026

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Directions to “ GAYLE CAMERON LCSW” Practice Location

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