Active NPI
Camille Liberatore, PSYD
- Psychologist
- Chicago, IL
National Provider Identifier
1205679677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 071011226
- Practice address
- 1300 W Belmont Ave Ste 10
Chicago, IL 60657-3200 - Phone
- (814) 594-5090
- NPI assigned
- Jun 14, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 071011226 | Primary |
Addresses
Primary practice location
1300 W Belmont Ave Ste 10
Chicago, IL 60657-3200
Mailing address
1300 W Belmont Ave Ste 10
Chicago, IL 60657-3200
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeview Psychology Group | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Psychologist
- Chicago, IL
- NPI 1134641103
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718323200000",
"number": "1205679677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 W BELMONT AVE STE 10",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606573200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 W BELMONT AVE STE 10",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606573200",
"telephone_number": "814-594-5090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIBERATORE",
"first_name": "CAMILLE",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-14",
"last_updated": "2024-06-14",
"certification_date": "2024-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": "071011226",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.