Provider Demographics
NPI:1215243696
Name:DOUGHER, CAMBER P (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CAMBER
Middle Name:P
Last Name:DOUGHER
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 1:295 ASHBOROUGH PARK
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30215-6515
Mailing Address - Country:US
Mailing Address - Phone:404-432-4245
Mailing Address - Fax:
Practice Address - Street 1:111 PETROL PT STE 202
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-1553
Practice Address - Country:US
Practice Address - Phone:404-432-4245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-24
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0042971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical