Camp Academia, Inc.

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

Legal business name

CAMP ACADEMIA, INC.

Practice address

907 New Franklin Rd
Lagrange, GA 30240-1203

Phone

(706) 884-4492

NPI assigned

Jun 4, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Shirley Pennebaker, M.ED.

Title

Founder and Ceo

Phone

(706) 884-4492

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1952142895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 NEW FRANKLIN RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302401203",
            "telephone_number": "706-884-4492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 NEW FRANKLIN RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302401203",
            "telephone_number": "706-884-4492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMP ACADEMIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "PENNEBAKER",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_title_or_position": "FOUNDER AND CEO",
        "authorized_official_telephone_number": "706-884-4492",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.ED."
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cognitive & Behavioral Psychologist in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Cognitive & Behavioral Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.

Verify at the official NPI Registry.