Provider Demographics
NPI:1528254612
Name:CAMAROTE, KELLEY WESCOTT (LGSW)
Entity type:Individual
Prefix:MRS
First Name:KELLEY
Middle Name:WESCOTT
Last Name:CAMAROTE
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BUILDING 1H AVE G
Mailing Address - Street 2:VA MEDICAL CENTER PERRY POINT
Mailing Address - City:PERRYVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21902
Mailing Address - Country:US
Mailing Address - Phone:410-642-2411
Mailing Address - Fax:
Practice Address - Street 1:BUILDING 1H AVE G
Practice Address - Street 2:VA MEDICAL CENTER PERRY POINT
Practice Address - City:PERRYVILLE
Practice Address - State:MD
Practice Address - Zip Code:21902
Practice Address - Country:US
Practice Address - Phone:410-642-2411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDG128471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical