| Camelot Outpatient Services, Llc | |
|
290 E Monroe St Wytheville VA 24382-2336 | |
| (276) 228-7200 | |
| (276) 228-7100 |
| Full Name | Camelot Outpatient Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 290 E Monroe St, Wytheville, Virginia |
| Authorized Official Name and Position | James D Long (SENIOR VP & CFO) |
| Authorized Official Contact | 5128589900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Camelot Outpatient Services, Llc 4207 E Highway 290 Dripping Springs TX 78620-4206 Ph: (512) 858-9900 | Camelot Outpatient Services, Llc 290 E Monroe St Wytheville VA 24382-2336 Ph: (276) 228-7200 |
| NPI Number | 1679896567 |
|---|---|
| Provider Enumeration Date | 03/05/2010 |
| Last Update Date | 03/05/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679896567 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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