Individual provider Active NPI

Camille Elise Keefe, MSW

  • Mental Health Counselor
  • Mount Vernon, WA
National Provider Identifier
1619503489
Registry record updated Mar 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
SC61041628 Issued in WA
Practice address
301 Valley Mall Way Ste 100
Mount Vernon, WA 98273-5462
Phone
(360) 428-1301
Fax
(360) 428-1302
NPI assigned
Mar 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X SC61041628 WA Primary

Addresses

Primary practice location

301 Valley Mall Way Ste 100
Mount Vernon, WA 98273-5462

Mailing address

301 Valley Mall Way Ste 100
Mount Vernon, WA 98273-5462
Phone (360) 428-1301

Other names 1

  • Camille Elise Danon Former name

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
SC61041628WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Regional Council PastSince Mar 22, 2020 Accepting new patients

Organizations & group practices 1

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": "1583971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1619503489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 VALLEY MALL WAY STE 100",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735462",
            "telephone_number": "360-428-1301",
            "fax_number": "360-428-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 VALLEY MALL WAY STE 100",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735462",
            "telephone_number": "360-428-1301",
            "fax_number": "360-428-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEFE",
        "first_name": "CAMILLE",
        "middle_name": "ELISE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-12",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "SC61041628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAMILLE",
            "last_name": "DANON",
            "middle_name": "ELISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; 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.