Active NPI
Andrea Marie Camicia-Logue, MS.OTR/L
- Occupational Therapist
- Lake Worth, FL
National Provider Identifier
1912722356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT25439
- Practice address
- 6684 Ashburn Rd
Lake Worth, FL 33467-7316 - Phone
- (561) 235-4566
- NPI assigned
- Nov 20, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT25439 | FL | Primary |
Addresses
Primary practice location
6684 Ashburn Rd
Lake Worth, FL 33467-7316
Mailing address
6684 Ashburn Rd
Lake Worth, FL 33467-7316
Phone (561) 235-4566
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT25439 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1732060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732492800000",
"number": "1912722356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6684 ASHBURN RD",
"city": "LAKE WORTH",
"state": "FL",
"postal_code": "334677316",
"telephone_number": "561-235-4566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6684 ASHBURN RD",
"city": "LAKE WORTH",
"state": "FL",
"postal_code": "334677316",
"telephone_number": "561-235-4566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMICIA-LOGUE",
"first_name": "ANDREA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "MS.OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-20",
"last_updated": "2024-11-25",
"certification_date": "2024-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT25439",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Worth, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.