Individual provider Active NPI

Dana Cammilleri, LPC

  • Professional Counselor
  • Racine, WI
National Provider Identifier
1487885489
Registry record updated Oct 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4795-125 Issued in WI
Practice address
420 7TH St
Racine, WI 53403-1222
Phone
(262) 634-2391
NPI assigned
Aug 7, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4795-125 WI Primary

Addresses

Primary practice location

420 7TH St
Racine, WI 53403-1222

Mailing address

420 7TH St
Racine, WI 53403-1222
Phone (262) 634-2391

Other identifiers 1

IdentifierTypeStateIssuer
DCAMMIL2998MedicaidWI

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

LicenseStateTypeSpecialty
4795-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Young Mens Christian Association PastSince Oct 31, 2021 Accepting new patients
Family Service of Racine PastSince Dec 20, 2016 Accepting new patients

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": "1249603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381795200000",
    "number": "1487885489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 7TH ST",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031222",
            "telephone_number": "262-634-2391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 7TH ST",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031222",
            "telephone_number": "262-634-2391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMMILLERI",
        "first_name": "DANA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-07",
        "last_updated": "2013-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4795-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DCAMMIL2998",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2013; 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.