Provider Demographics
NPI:1306334305
Name:DORMENT, CAMILLA POWER (LICSW)
Entity type:Individual
Prefix:
First Name:CAMILLA
Middle Name:POWER
Last Name:DORMENT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 CONNECTICUT AVE NW
Mailing Address - Street 2:SUITE 300 EAST
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036
Mailing Address - Country:US
Mailing Address - Phone:202-329-8640
Mailing Address - Fax:
Practice Address - Street 1:1555 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE 300 EAST
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036
Practice Address - Country:US
Practice Address - Phone:202-329-8640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-25
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker