Camille Vaughn
Individual provider Active NPI Clinical Social Worker · Bronx, NY
NPI 1679718969 · NPPES record last updated Dec 16, 2008
Key facts
- NPI
- 1679718969
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Practice address
- 55 Westchester SQ
Bronx, NY 10461-3525 - Phone
- (718) 931-4045
- NPI assigned
- Dec 16, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NY, CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241205002101 | NY | Practitioner - Clinical Social Worker | 3274069943 | |
| I20250221001427 | CA | Practitioner - Clinical Social Worker | 3274069943 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Clinical | Current | Accepting new patients |
| Jewish Board of Family and Children Services | Past | Accepting new patients |
Interoperability endpoints
- camillevaughn@tdh.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Yes |
Addresses
Primary practice location
55 Westchester SQ
Bronx, NY 10461-3525
Mailing address
4065 Ely Ave
Bronx, NY 10466-2207
Phone (718) 300-9288
Other providers in Bronx, NY
- Vaibhav Vinod Vats
- Akhil Deepak Vatvani
- Anisa Karmella Symone Vaughan
- Dorothy Vaughan
- Marsha Vaughan
- Sydney Marie Vaughn
- Toni Vaughn
- Robert Vavolizza
- Sumayya Vawda
- Rebecca Mary Vayalumkal
All providers in Bronx, NY · Clinical Social Worker in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.