Provider Demographics
NPI:1194530477
Name:STOVER-DONAUBAUER, CAMERON SELINA
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:SELINA
Last Name:STOVER-DONAUBAUER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 LENOX AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-4434
Mailing Address - Country:US
Mailing Address - Phone:212-876-5500
Mailing Address - Fax:
Practice Address - Street 1:317 LENOX AVE FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-4434
Practice Address - Country:US
Practice Address - Phone:212-949-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health