Cameron Lee Small, MS, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC02017 Issued in MN

Practice address

9156 Vincent Ave S
Bloomington, MN 55431

Phone

(608) 338-5707

NPI assigned

Jan 2, 2019

Last updated

Jun 18, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1546387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1275006215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9156 VINCENT AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "55431",
            "telephone_number": "608-338-5707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9156 VINCENT AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "55431",
            "telephone_number": "608-338-5707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "CAMERON",
        "middle_name": "LEE",
        "credential": "MS, LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-02",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC02017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariam K Slayhi, PTA,LMT,CLT
• Mikayla Slegh
• Savanna Slettom
• Joel Donald Slinden, PA-C
• Kristin Jeffrey Slocum
• Emmett Small
• Jeffrey James Smidt, D.C.
• Amy M Smith, PA
• Brandon Lee Smith, PHARM.D.
• Charley Smith

• Professional Counselor in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.

Verify at the official NPI Registry.