Individual provider Active NPI

Celia Ann Kamps, PH.D.

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1376790097
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
076852 Issued in NY
Practice address
1950 Coronada St
Ann Arbor, MI 48103-5014
Phone
(315) 559-9869
NPI assigned
Aug 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801115998 MI
Clinical Social Worker 1041C0700X 149.022840 IL
Clinical Social Worker 1041C0700X 6801115998 MI
Clinical Social Worker 1041C0700X 076852 NY Primary

Addresses

Primary practice location

1950 Coronada St
Ann Arbor, MI 48103-5014

Mailing address

1950 Coronada St
Ann Arbor, MI 48103-5014
Phone (315) 559-9869

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20111116000452 NY Practitioner - Clinical Social Worker 4284808866 Reassigns benefits to 2 organizations
I20240425003648 MI Practitioner - Clinical Social Worker 4284808866 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
149.022840ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty Resources, Inc. CurrentSince Jul 22, 2013 Accepting new patients
Liberty Resources Inc. CurrentSince Jul 22, 2013 Accepting new patients
Psychiatry Faculty Practice, Inc. CurrentSince Mar 4, 2019 Accepting new patients

Locations

713 Harrison St
Bldg 3
Syracuse, NY 13210
Phone (315) 464-3265

1045 James St
Syracuse, NY 13203
Phone (315) 425-1004

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1376790097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 CORONADA ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481035014",
            "telephone_number": "315-559-9869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 CORONADA ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481035014",
            "telephone_number": "315-559-9869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMPS",
        "first_name": "CELIA",
        "middle_name": "ANN",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-25",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801115998",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.022840",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801115998",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "076852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.