Provider Demographics
NPI:1437517034
Name:CAMP, MELANIEANN (LMSW, LCDC, SAP)
Entity type:Individual
Prefix:
First Name:MELANIEANN
Middle Name:
Last Name:CAMP
Suffix:
Gender:F
Credentials:LMSW, LCDC, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2904 E STAN SCHLUETER LOOP
Mailing Address - Street 2:#38
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-4813
Mailing Address - Country:US
Mailing Address - Phone:254-400-9931
Mailing Address - Fax:866-873-4947
Practice Address - Street 1:100 W CENTRAL TEXAS EXPY
Practice Address - Street 2:#310
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-2079
Practice Address - Country:US
Practice Address - Phone:254-400-9931
Practice Address - Fax:866-873-4947
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-10
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11832101YA0400X
TX52737104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker