Diane Elizabeth Camp, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P0000001528 Issued in TN

Practice address

5100 Poplar Ave
Suite 510
Memphis, TN 38137-4000

Phone

(901) 572-1726

Fax

(901) 562-0386

NPI assigned

Sep 14, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Optimum Behavioral Health, Inc.

  • Clinical Psychologist
  • Memphis, TN
  • NPI 1689655268
  NPD (past)
• Midsouth Behavioral Health, PLLC

  • Clinical Psychologist
  • Olive Branch, MS
  • NPI 1912084286
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493510400000",
    "number": "1649375619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 POPLAR AVE",
            "address_2": "SUITE 510",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381374000",
            "telephone_number": "901-572-1726",
            "fax_number": "901-562-0386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 POPLAR AVE",
            "address_2": "SUITE 510",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381374000",
            "telephone_number": "901-572-1726",
            "fax_number": "901-562-0386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMP",
        "first_name": "DIANE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2017-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P0000001528",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MS",
            "license": "31-455",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cambridge Adult Day Services - Millbranch
• Camellia Counseling
• Camelot Care Centers, Inc
• Francis X Camillo, M.D.
• Charissa C Camp, PH.D., ABPP
• Campbell Clinic
• Campbell Clinic PC
• Campbell Clinic PC
• Campbell Clinic PC
• Campbell Clinic PC

• Clinical Psychologist in Memphis, TN
• Providers in Memphis, TN by specialty
• Clinical Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2017; 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.