Nicole L Cammack, PH.D.
Individual provider Active NPI Clinical Psychologist · Washington, DC
NPI 1699144113 · NPPES record last updated Jan 18, 2022
Key facts
- NPI
- 1699144113
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 05412 (MD)
- Practice address
- 50 Irving St NW
Washington, DC 20422-7081 - Phone
- (202) 745-8000
- NPI assigned
- Sep 15, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05412 | MD | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healing Generations Psychological Services and Consultation Center | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 05412 | MD | Yes |
Addresses
Primary practice location
50 Irving St NW
Washington, DC 20422-7081
Mailing address
2480 Llewellyn Ave
Fort George G Meade, MD 20755-7081
Phone (240) 412-3437
Other practice location 1
475 K St NW Unit 1027
Washington, DC 20001-5271
Phone (703) 594-6794
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All providers in Washington, DC · Clinical Psychologist in District of Columbia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.