Individual provider Active NPI

Camille Markward

  • Clinical Psychologist
  • Mt Sterling, KY
National Provider Identifier
1376818658
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
245318 Issued in KY
Practice address
300 Foxglove Dr
Mt Sterling, KY 40353-9769
Phone
(859) 498-2135
Fax
(859) 498-7547
NPI assigned
Mar 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Clinical Psychologist 103TC0700X 245318 KY Primary

Addresses

Primary practice location

300 Foxglove Dr
Mt Sterling, KY 40353-9769

Mailing address

PO Box 790
Ashland, KY 41105-0790
Phone (606) 329-8588

Other identifiers 1

IdentifierTypeStateIssuer
30610026MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240214002276 KY Practitioner - Mental Health Counselor 4385088665 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
245318KYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Inc Current Accepting new patients
Pathways, Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

3701 Landsdowne Dr
Ashland, KY 41102
Phone (606) 324-3005

300 Foxglove Dr
Mt Sterling, KY 40353
Phone (800) 562-8909

Organizations & group practices 2

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": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1376818658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 790",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411050790",
            "telephone_number": "606-329-8588",
            "fax_number": "606-329-8195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FOXGLOVE DR",
            "city": "MT STERLING",
            "state": "KY",
            "postal_code": "403539769",
            "telephone_number": "859-498-2135",
            "fax_number": "859-498-7547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKWARD",
        "first_name": "CAMILLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-20",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "245318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30610026",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Sterling, KY

Sources for this page

Verify at the official NPI Registry.