Cammi Shoultz, DLLP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6351004839 Issued in MI

Practice address

25900 Greenfield Rd Ste 100
Oak Park, MI 48237-1297

Phone

(248) 788-4300

Fax

(248) 605-8099

NPI assigned

Oct 8, 2025

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

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Clinical Psychologist

Education

Nova Southeastern College of Osteo Medicine, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Life Skills Village, PLLC

  • Community/Behavioral Health Agency
  • Oak Park, MI
  • NPI 1629316815
  Medicare reassignment NPD

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

{
    "created_epoch": "1759881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1932074911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25900 GREENFIELD RD STE 100",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482371297",
            "telephone_number": "248-788-4300",
            "fax_number": "248-605-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25900 GREENFIELD RD STE 100",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482371297",
            "telephone_number": "248-788-4300",
            "fax_number": "248-605-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOULTZ",
        "first_name": "CAMMI",
        "credential": "DLLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-08",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6351004839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jenny Phu Shih, D.O.
• Shining Stars Therapy LLC
• Sehra Sarwar Siddiqui, OTR
• Signs of Recovery Case Management LLC (Signs of Recovery Case Management LLC, Ein 82-0838736)
• Simply Au-Some
• Simply Perfect Residential Care LLC
• Trina Simpson

• Psychologist in Oak Park, MI
• Providers in Oak Park, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.