Individual provider Active NPI

Michael Casey Vancamp, LPC

  • Professional Counselor
  • Knoxville, TN
National Provider Identifier
1174037261
Registry record updated Sep 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3648 Issued in TN
Practice address
1451 Dowell Springs Blvd
Knoxville, TN 37909
Phone
(865) 970-9800
Fax
(865) 374-7317
NPI assigned
Nov 28, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3648 TN Primary

Addresses

Primary practice location

1451 Dowell Springs Blvd
Knoxville, TN 37909

Mailing address

1451 Dowell Springs Blvd
Knoxville, TN 37909-2441
Phone (865) 970-9800

Other practice location 1

1451 Dowell Springs Blvd
Knoxville, TN 37909
Phone (865) 970-9800

Other identifiers 1

IdentifierTypeStateIssuer
Q038547MedicaidTN

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

NPI Registry JSON

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

{
    "created_epoch": "1511827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536710400000",
    "number": "1174037261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 DOWELL SPRINGS BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092441",
            "telephone_number": "865-970-9800",
            "fax_number": "865-374-7317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 DOWELL SPRINGS BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37909",
            "telephone_number": "865-970-9800",
            "fax_number": "865-374-7317"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1451 Dowell Springs Blvd",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "37909",
            "country_code": "US",
            "telephone_number": "865-970-9800",
            "fax_number": "865-374-7317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANCAMP",
        "first_name": "MICHAEL",
        "middle_name": "CASEY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-28",
        "last_updated": "2018-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "3648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q038547",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.