Provider Demographics
NPI:1114814472
Name:CAMMARANO, ALEXANDRIA SMITH (PHD, LCMHCA, NCC)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:SMITH
Last Name:CAMMARANO
Suffix:
Gender:F
Credentials:PHD, LCMHCA, NCC
Other - Prefix:
Other - First Name:ALEX
Other - Middle Name:
Other - Last Name:CAMMARANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD, LCMHCA, NCC
Mailing Address - Street 1:1205 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-5762
Mailing Address - Country:US
Mailing Address - Phone:336-684-9951
Mailing Address - Fax:336-513-0554
Practice Address - Street 1:1205 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5762
Practice Address - Country:US
Practice Address - Phone:336-684-9951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA20423101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health