Individual provider Active NPI

Cami Hambrock, MS

  • Professional Counselor
  • Bemidji, MN
National Provider Identifier
1750054565
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
112 1St St W
Bemidji, MN 56601-4002
Phone
(812) 888-8032
Fax
(812) 888-8033
NPI assigned
Jul 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

112 1St St W
Bemidji, MN 56601-4002

Mailing address

112 1St St W
Bemidji, MN 56601-4002
Phone (812) 888-8032

Other practice location 1

2100 Goshen Rd
Fort Wayne, IN 46808-1493
Phone (260) 471-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240325002738 MN Practitioner - Mental Health Counselor 4082051156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

203 14TH St NE
East Grand Forks, MN 56721-1626
Phone (218) 693-2014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD CurrentSince Mar 1, 2024 Accepting new patients

Locations

112 1st St W
Bemidji, MN 56601
Phone (218) 888-8032

203 14th St NE
East Grand Forks, MN 56721
Phone (218) 693-2014

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

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": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1750054565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 1ST ST W",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014002",
            "telephone_number": "812-888-8032",
            "fax_number": "812-888-8033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 1ST ST W",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014002",
            "telephone_number": "812-888-8032",
            "fax_number": "812-888-8033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Goshen Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468081493",
            "country_code": "US",
            "telephone_number": "260-471-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMBROCK",
        "first_name": "CAMI",
        "name_prefix": "Mrs.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bemidji, MN

Sources for this page

Verify at the official NPI Registry.