Camille Coleman, BA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

830644 Issued in GA

Practice address

3416 Timbercreek Dr
Lawrenceville, GA 30044-3050

Phone

(470) 321-3346

NPI assigned

Jun 23, 2010

Last updated

Mar 24, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Camille J Gregory Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Safety Net Youth Services

  • Addiction (Substance Use Disorder) Counselor
  • Lawrenceville, GA
  • NPI 1477203347
  NPD
• Alleghany Highlands Community Services

  • Community/Behavioral Health Agency
  • Covington, VA
  • NPI 1730136151
  NPD
• Alleghany Highlands Community Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Covington, VA
  • NPI 1518055367
  NPD (past)

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

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1063723286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8555 TAFT ST",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106123",
            "telephone_number": "219-769-4005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3416 TIMBERCREEK DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300443050",
            "telephone_number": "470-321-3346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8555 Taft St",
            "address_purpose": "LOCATION",
            "city": "Merrillville",
            "state": "IN",
            "postal_code": "464106123",
            "country_code": "US",
            "telephone_number": "219-769-4005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "CAMILLE",
        "credential": "BA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-23",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "830644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAMILLE",
            "last_name": "GREGORY",
            "middle_name": "J",
            "credential": "MSHS ICAADC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Cassin Cole-Straub, PSY.D.
• Alison Rene Cole, LPC
• Kimberley Renee Cole, APRN
• Louis D Cole, M.D.
• Lyndsey Cole, CRNA
• Emily Coleman
• Brittany Renay Coles, LPC
• Jason C Colier, PAAA
• Collaborating Minds LLC
• Collaborating Minds Mental Health & Wellness LLC

• Addiction (Substance Use Disorder) Counselor in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Addiction (Substance Use Disorder) Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.