Active NPI
Camille Ridgley, MA, NCC, LPC
- Professional Counselor
- Rincon, GA
National Provider Identifier
1194537589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC015355
- Practice address
- 102 Timber Creek Dr
Rincon, GA 31326-5919 - Phone
- (912) 521-4690
- NPI assigned
- Jan 22, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC015355 | GA | Primary |
Addresses
Primary practice location
102 Timber Creek Dr
Rincon, GA 31326-5919
Mailing address
102 Timber Creek Dr
Rincon, GA 31326
Phone (912) 401-1462
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC015355 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1737504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737676800000",
"number": "1194537589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 TIMBER CREEK DR",
"city": "RINCON",
"state": "GA",
"postal_code": "31326",
"telephone_number": "912-401-1462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 TIMBER CREEK DR",
"city": "RINCON",
"state": "GA",
"postal_code": "313265919",
"telephone_number": "912-521-4690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIDGLEY",
"first_name": "CAMILLE",
"credential": "MA, NCC, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-01-22",
"last_updated": "2025-01-24",
"certification_date": "2025-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC015355",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rincon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.