Active NPI
Camielle Famous, M.S.
- Professional Counselor
- Saint Louis, MO
National Provider Identifier
1790125219
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2012015292
- Practice address
- 4144 Lindell Blvd Ste 140
Saint Louis, MO 63108-2931 - Phone
- (314) 896-4245
- NPI assigned
- Jun 28, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2012015292 | MO | Primary |
Addresses
Primary practice location
4144 Lindell Blvd Ste 140
Saint Louis, MO 63108-2931
Mailing address
4144 Lindell Blvd Ste 140
Saint Louis, MO 63108-2931
Phone (314) 896-4245
Other practice location 1
380 East Highway CC
Suite A105
Nixa, MO 65714
Phone (417) 725-8810
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790125219 | Medicaid | MO |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2012015292 | MO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Barbara K. Hylton | Past | Accepting new patients | |
| CC Counseling Services,LLC | Professional | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Nixa, MO
- NPI 1750504544
-
- Professional Counselor
- Nixa, MO
- NPI 1912168733
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537920000000",
"number": "1790125219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4144 LINDELL BLVD STE 140",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631082931",
"telephone_number": "314-896-4245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4144 LINDELL BLVD STE 140",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631082931",
"telephone_number": "314-896-4245"
}
],
"practiceLocations": [
{
"address_1": "380 East Highway CC",
"address_2": "Suite A105",
"address_purpose": "LOCATION",
"city": "Nixa",
"state": "MO",
"postal_code": "65714",
"country_code": "US",
"telephone_number": "417-725-8810",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FAMOUS",
"first_name": "CAMIELLE",
"name_prefix": "Ms.",
"credential": "M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-06-28",
"last_updated": "2018-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2012015292",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1790125219",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.