Provider Demographics
NPI:1518779156
Name:CAMERON, CAROLINE VIRGINIA (MA)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:VIRGINIA
Last Name:CAMERON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 NOCTURNE WOODS PL
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-1452
Mailing Address - Country:US
Mailing Address - Phone:281-363-0975
Mailing Address - Fax:
Practice Address - Street 1:10210 GROGANS MILL RD STE 145
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1144
Practice Address - Country:US
Practice Address - Phone:281-222-6247
Practice Address - Fax:844-475-2309
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-21
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX97250101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health