Provider Demographics
NPI:1053536367
Name:HARRIS, CAMEO TUESDAY (LCSW)
Entity type:Individual
Prefix:MS
First Name:CAMEO
Middle Name:TUESDAY
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 THIMBLE SHOALS BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4262
Mailing Address - Country:US
Mailing Address - Phone:757-753-5812
Mailing Address - Fax:
Practice Address - Street 1:732 THIMBLE SHOALS BLVD STE 202
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4262
Practice Address - Country:US
Practice Address - Phone:175-753-5812
Practice Address - Fax:757-223-7856
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2262261QM0801X
VA09040065351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)