Cameron Vonwald

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

115 S Main St
Noble, OK 73068-9622

Phone

(405) 872-8461

NPI assigned

Dec 22, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Impact Counseling Center LLC

  • Counselor
  • Noble, OK
  • NPI 1730583402

  Mental Health

  NPD

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

{
    "created_epoch": "1608595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1972190098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 S MAIN ST",
            "city": "NOBLE",
            "state": "OK",
            "postal_code": "730689622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S MAIN ST",
            "city": "NOBLE",
            "state": "OK",
            "postal_code": "730689622",
            "telephone_number": "405-872-8461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONWALD",
        "first_name": "CAMERON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-22",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200561790B",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cameron@impactcounselingcenter.com",
            "affiliation": "N",
            "address_1": "115 S Main St",
            "city": "Noble",
            "state": "OK",
            "country_code": "US",
            "postal_code": "730689622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dalton T Thurman, DC
• Casey Martin Todd, PHARMD
• Gary Neal Todd, DPH
• Linda M Todd, DPH
• Keirsten L Underwood, M.S. CCC-SLP
• Wandro Dental of Noble
• Ashley Webb
• Suzanne K. Wells
• Lola Williams, MA,CCC,SLP
• Sandra Kay Wilson

• Mental Health Counselor in Noble, OK
• Providers in Noble, OK by specialty
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; 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.