Provider Demographics
NPI:1619666088
Name:ZAMORA, ALBAN CAMILO (LGSW, LMSW)
Entity type:Individual
Prefix:
First Name:ALBAN
Middle Name:CAMILO
Last Name:ZAMORA
Suffix:
Gender:M
Credentials:LGSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2324 ASHMEAD PL NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-1414
Mailing Address - Country:US
Mailing Address - Phone:830-822-4493
Mailing Address - Fax:
Practice Address - Street 1:2970 BELCREST CENTER DR UNIT 301
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-1987
Practice Address - Country:US
Practice Address - Phone:240-714-5247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29738104100000X
DCLG200002306104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker