Doctor Name: | MRS. MARY KATHERINE VAN CAMP |
NPI Number: | 1093828535 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW, ACSW |
License Number: | 6801070602 |
Business Practice Address: | 787 Market St. Suites 9 & 10 Hancock, MI - 49930 |
Business Phone Number: | 9064827762 |
Business Fax Number: | 9064827893 |
Mailing Address: | 787 Market St., Suites 9 &10 HANCOCK |
State: | MI |
Postal Code: | 49930 |
Phone Number: | 9064827762 |
Fax Number: | 9064827893 |
NPI Enumeration Date: | 08/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6801070602 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |