Active NPI
Camron L Whitacre, MS.ED., LPCC-S, LMHC
- Professional Counselor
- Kettering, OH
National Provider Identifier
1487880316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- E.0008476
- Practice address
- 1563 E Dorothy LN
Suite 300B
Kettering, OH 45429-3897 - Phone
- (937) 938-6067
- Fax
- (937) 938-6067
- NPI assigned
- Jun 5, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | E.0008476 | OH | Primary |
| Mental Health Counselor | 101YM0800X | 39004229A | IN |
Addresses
Primary practice location
1563 E Dorothy LN
Suite 300B
Kettering, OH 45429-3897
Mailing address
1563 E Dorothy LN
Suite 300B
Kettering, OH 45429-3897
Phone (937) 938-6067
Other practice location 1
70 E 91st St
Indianapolis, IN 46240-1561
Phone (937) 903-4953
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0178113 | Medicaid | OH |
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 |
|---|---|---|---|
| 39004229A | IN | MD | Mental Health Counselor |
| E.0008476 | OH | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656633600000",
"number": "1487880316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1563 E DOROTHY LN",
"address_2": "SUITE 300B",
"city": "KETTERING",
"state": "OH",
"postal_code": "454293897",
"telephone_number": "937-938-6067",
"fax_number": "937-938-6067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1563 E DOROTHY LN",
"address_2": "SUITE 300B",
"city": "KETTERING",
"state": "OH",
"postal_code": "454293897",
"telephone_number": "937-938-6067",
"fax_number": "937-938-6067"
}
],
"practiceLocations": [
{
"address_1": "70 E 91st St",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462401561",
"country_code": "US",
"telephone_number": "937-903-4953",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WHITACRE",
"first_name": "CAMRON",
"middle_name": "L",
"credential": "MS.ED., LPCC-S, LMHC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-05",
"last_updated": "2022-07-01",
"certification_date": "2022-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "E.0008476",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39004229A",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0178113",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kettering, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.