Provider Demographics
NPI:1093434565
Name:SHORT, CAMERON (MA, LCMHC)
Entity type:Individual
Prefix:MS
First Name:CAMERON
Middle Name:
Last Name:SHORT
Suffix:
Gender:F
Credentials:MA, LCMHC
Other - Prefix:
Other - First Name:CAMERON
Other - Middle Name:
Other - Last Name:SCROGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:110 HOLLY HILL ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28638-2460
Mailing Address - Country:US
Mailing Address - Phone:828-292-8731
Mailing Address - Fax:
Practice Address - Street 1:110 HOLLY HILL ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NC
Practice Address - Zip Code:28638-2460
Practice Address - Country:US
Practice Address - Phone:828-292-8731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NC18038101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCA18038OtherNC LICENSE