MEDICARE: CAMILLE HEHN LCSW-R

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	R034603-1	NY

General Provider Information

NPI Number	:	1982226627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMILLE HEHN LCSW-R

Provider Business Mailing Address
First Line	:	527 BRADFORD ST
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12206-1432
Country	:	US
Telephone Number	:	518-237-3572
Fax Number	:

Provider Business Practice Location Address
First Line	:	527 BRADFORD ST
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12206-1432
Country	:	US
Telephone Number	:	518-237-3572
Fax Number	:

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

Provider Enumeration Date	:	05/16/2020
Last Update Date	:	05/16/2020

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