Active NPI
Camille Deitz, LCPC
- Professional Counselor
- Kalispell, MT
National Provider Identifier
1154964302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- BBH-LCPC-LIC-42981
- Practice address
- 17 2ND St E Ste 210
Kalispell, MT 59901-4500 - Phone
- (406) 471-6844
- NPI assigned
- Oct 21, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | BBH-PCLC-LIC-32538 | MT | |
| Professional Counselor | 101YP2500X | BBH-LCPC-LIC-42981 | MT | Primary |
Addresses
Primary practice location
17 2ND St E Ste 210
Kalispell, MT 59901-4500
Mailing address
17 2ND St E Ste 210
Kalispell, MT 59901-4500
Phone (406) 471-6844
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BBH-PCLC-LIC-32538 | MT | MD | Mental Health Counselor |
| BBH-LCPC-LIC-42981 | MT | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590969600000",
"number": "1154964302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 2ND ST E STE 210",
"city": "KALISPELL",
"state": "MT",
"postal_code": "599014500",
"telephone_number": "406-471-6844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 2ND ST E STE 210",
"city": "KALISPELL",
"state": "MT",
"postal_code": "599014500",
"telephone_number": "406-471-6844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEITZ",
"first_name": "CAMILLE",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-21",
"last_updated": "2020-06-01",
"certification_date": "2020-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MT",
"license": "BBH-PCLC-LIC-32538",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MT",
"license": "BBH-LCPC-LIC-42981",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kalispell, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.