Active NPI
Cordelia Ruth Cameron, LPC
- Mental Health Counselor
- Pueblo, CO
National Provider Identifier
1285938407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 276
- Practice address
- 429 W. 10TH St.
Pueblo, CO 81003-2941 - Phone
- (719) 586-8611
- Fax
- (719) 544-4215
- NPI assigned
- Jan 3, 2011
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 276 | CO | Primary |
Addresses
Primary practice location
429 W. 10TH St.
Pueblo, CO 81003-2941
Mailing address
429 W. 10 St.
Pueblo, CO 81003-2941
Phone (719) 586-8611
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 |
|---|---|---|---|
| 276 | CO | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Catholic Charities of the Diocese of Pueblo | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Pueblo's Family Resource Center
- Case Management Agency
- Pueblo, CO
- NPI 1629670088
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294012800000",
"number": "1285938407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "429 W. 10 ST.",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810032941",
"telephone_number": "719-586-8611",
"fax_number": "719-544-4215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "429 W. 10TH ST.",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810032941",
"telephone_number": "719-586-8611",
"fax_number": "719-544-4215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMERON",
"first_name": "CORDELIA",
"middle_name": "RUTH",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-03",
"last_updated": "2011-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CO",
"license": "276",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.