NPIMap

Organization Active NPI

Camelot Outpatient Services, LLC

  • Psychologist
  • Wytheville, VA
National Provider Identifier
1679896567
Registry record updated Mar 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
CAMELOT OUTPATIENT SERVICES, LLC
Practice address
290 E Monroe St
Wytheville, VA 24382-2336
Phone
(276) 228-7200
Fax
(276) 228-7100
NPI assigned
Mar 5, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2010

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

Authorized official

Name
James D Long
Title
Senior VP & Cfo
Phone
(512) 858-9900

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101Y00000X
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

290 E Monroe St
Wytheville, VA 24382-2336

Mailing address

4207 E Highway 290
Dripping Springs, TX 78620-4206
Phone (512) 858-9900

National Provider Directory

National Provider Directory
Tax ID family
Camelot Outpatient Services LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1267747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267747200000",
    "number": "1679896567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4207 E HIGHWAY 290",
            "city": "DRIPPING SPRINGS",
            "state": "TX",
            "postal_code": "786204206",
            "telephone_number": "512-858-9900",
            "fax_number": "512-858-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 E MONROE ST",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243822336",
            "telephone_number": "276-228-7200",
            "fax_number": "276-228-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMELOT OUTPATIENT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-05",
        "last_updated": "2010-03-05",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "SENIOR VP & CFO",
        "authorized_official_telephone_number": "512-858-9900"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wytheville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2010; 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.