NPIMap

Organization Active NPI

Camas Professional Counseling

  • Community/Behavioral Health Agency
  • Grangeville, ID
National Provider Identifier
1033326301
Registry record updated Sep 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CAMAS PROFESSIONAL COUNSELING
Practice address
304 N State St
Grangeville, ID 83530-1769
Phone
(208) 983-0235
Fax
(208) 983-0245
NPI assigned
May 17, 2007
Last updated
Sep 9, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tammy Lee Everson, LCSWNPI 1245422625
Title
Clinical/Owner
Phone
(208) 983-0235

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X ID Primary

Addresses

Primary practice location

304 N State St
Grangeville, ID 83530-1769

Mailing address

304 N State St
PO Box 627
Grangeville, ID 83530-1769
Phone (208) 983-0235

Other identifiers 5

IdentifierTypeStateIssuer
807068700MedicaidID
807353600MedicaidID
807068800MedicaidID
807098900MedicaidID
807099000MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071204000702 ID Part B Supplier - Clinic/Group Practice 3476579160 Receives reassigned benefits from 3 practitioners
Practice locations: Grangeville, ID

National Provider Directory

National Provider Directory
Tax ID family
Camas Prof Cnsling2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

102 N College St
Grangeville, ID 83530
Phone (208) 983-0235

304 N State St
Grangeville, ID 83530
Phone (208) 983-0235

320 E Main St
Grangeville, ID 83530
Phone (208) 983-0235

511 Main St
Kamiah, ID 83536
Phone (208) 935-0363

504 Main St
Ste 420
Lewiston, ID 83501
Phone (208) 798-4590

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441756800000",
    "number": "1033326301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 N STATE ST",
            "address_2": "PO BOX 627",
            "city": "GRANGEVILLE",
            "state": "ID",
            "postal_code": "835301769",
            "telephone_number": "208-983-0235",
            "fax_number": "208-983-0245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 N STATE ST",
            "city": "GRANGEVILLE",
            "state": "ID",
            "postal_code": "835301769",
            "telephone_number": "208-983-0235",
            "fax_number": "208-983-0245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMAS PROFESSIONAL COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2015-09-09",
        "status": "A",
        "authorized_official_last_name": "EVERSON",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CLINICAL/OWNER",
        "authorized_official_telephone_number": "208-983-0235",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807068700",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807353600",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807068800",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807098900",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807099000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grangeville, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.