Individual provider Active NPI

Chelsea Cameron

  • Marriage & Family Therapist
  • Maitland, FL
National Provider Identifier
1518633247
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT3526 Issued in FL
Practice address
100 E Sybelia Ave Ste 380
Maitland, FL 32751-4775
Phone
(630) 699-2683
NPI assigned
Aug 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH16154 FL
Marriage & Family Therapist 106H00000X MT3526 FL Primary

Addresses

Primary practice location

100 E Sybelia Ave Ste 380
Maitland, FL 32751-4775

Mailing address

100 E Sybelia Ave Ste 380
Maitland, FL 32751-4775
Phone (630) 699-2683

Other practice location 1

20218 19th Dr SE Apt B
Bothell, WA 98012-7164
Phone (630) 699-2683

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://c3.secure-client-area.com/

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
MH16154FLMDMental Health Counselor
MT3526FLMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1629590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1518633247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E SYBELIA AVE STE 380",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514775",
            "telephone_number": "630-699-2683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E SYBELIA AVE STE 380",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514775",
            "telephone_number": "630-699-2683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20218 19th Dr SE Apt B",
            "address_purpose": "LOCATION",
            "city": "Bothell",
            "state": "WA",
            "postal_code": "980127164",
            "country_code": "US",
            "telephone_number": "630-699-2683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMERON",
        "first_name": "CHELSEA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-22",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH16154",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT3526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://c3.secure-client-area.com/",
            "affiliation": "N",
            "address_1": "100 E Sybelia Ave Ste 380",
            "city": "Maitland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327514775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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.