Provider Demographics
NPI:1063739191
Name:GAYLE, CAMILE S (LCSW)
Entity type:Individual
Prefix:MS
First Name:CAMILE
Middle Name:S
Last Name:GAYLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22053 PALMS WAY
Mailing Address - Street 2:APT #202
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-8091
Mailing Address - Country:US
Mailing Address - Phone:917-573-5411
Mailing Address - Fax:
Practice Address - Street 1:900 NE 18TH AVE
Practice Address - Street 2:1207
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304-3063
Practice Address - Country:US
Practice Address - Phone:917-573-5411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-29
Last Update Date:2015-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCD (DONA)374J00000X
NY079651-11041C0700X
FLSW112841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No374J00000XNursing Service Related ProvidersDoula