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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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

LicenseStateTypeSpecialty
05412MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Generations Psychological Services and Consultation Center Current
since Jan 26, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Washington, DC

All providers in Washington, DC · Clinical Psychologist in District of Columbia

Sources for this page

Verify at the official NPI Registry.