Provider Demographics
NPI:1841178068
Name:BEAUBIEN, CAMILLE (LMSW)
Entity type:Individual
Prefix:
First Name:CAMILLE
Middle Name:
Last Name:BEAUBIEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 SAINT EDWARDS ST APT 10A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-5222
Mailing Address - Country:US
Mailing Address - Phone:347-962-4735
Mailing Address - Fax:
Practice Address - Street 1:112 SAINT EDWARDS ST APT 10A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-5222
Practice Address - Country:US
Practice Address - Phone:347-962-4735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY128371-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker