Camila Oliveira De Azevedo, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C.1500337-TRNE Issued in OH

Practice address

1617 W Foster Ave FL 1
Chicago, IL 60640-2013

Phone

(312) 907-8552

NPI assigned

Jul 1, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Camila Azevedo Feldstein Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Origem Psychotherapy LLC

  • Mental Health Counselor
  • Chicago, IL
  • NPI 1750040341
  NPD Authorized official

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640908800000",
    "number": "1861875452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1617 W FOSTER AVE FL 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402013",
            "telephone_number": "312-907-8552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 W FOSTER AVE FL 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402013",
            "telephone_number": "312-907-8552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE AZEVEDO",
        "first_name": "CAMILA",
        "middle_name": "OLIVEIRA",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-01",
        "last_updated": "2021-12-31",
        "certification_date": "2021-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.1500337-TRNE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAMILA",
            "last_name": "FELDSTEIN",
            "middle_name": "AZEVEDO",
            "credential": "LPC, CT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• DCP of Illinois (Irving Park), LTD.
• Katie Genevieve Dcruz, AGNP-C
• Savio Dcruz
• Ivan De Alba Romero, LSW
• Delia De Avila, LCSW
• Dennis De Biase
• Lillian M. De Blecourt, LCSW
• Elise Anjalee De Bruyn
• Andree C. De Bustros, M.D.
• Eveline De Castro, M.S., CCC-SLP/L

• Mental Health Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2021; 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.