Provider Demographics
NPI:1336891993
Name:ALEXANDER, CAMILLE A (LCSW)
Entity type:Individual
Prefix:DR
First Name:CAMILLE
Middle Name:A
Last Name:ALEXANDER
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 1:6039 GLASS PEAK LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-2895
Mailing Address - Country:US
Mailing Address - Phone:425-406-9099
Mailing Address - Fax:
Practice Address - Street 1:6039 GLASS PEAK LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-2895
Practice Address - Country:US
Practice Address - Phone:425-406-9099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-24
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW610760971041C0700X
TX1112241041C0700X
VT089.01360251041C0700X
LA130911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical