MEDICARE: CAMBER DOUGHER, 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	CSW004297	GA

General Provider Information

NPI Number	:	1942655956
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAMBER DOUGHER, LCSW

Provider Business Mailing Address
First Line	:	295 ASHBOROUGH PARK
Second Line	:
City	:	FAYETTEVILLE
State	:	GA
Zip	:	30215-6515
Country	:	US
Telephone Number	:	404-432-4245
Fax Number	:

Provider Business Practice Location Address
First Line	:	262 S PEACHTREE PKWY
Second Line	:	STE 4
City	:	PEACHTREE CITY
State	:	GA
Zip	:	30269-1751
Country	:	US
Telephone Number	:	404-432-4245
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CAMBER DOUGHER
Credential	:	LCSW
Telephone Number	:	404-432-4245

Provider Enumeration Date	:	04/27/2016
Last Update Date	:	04/27/2016

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