Courtney Camino, LPC, NCSP,

Individual provider Active NPI School Psychologist · Douglas, WY

NPI 1972240398 · NPPES record last updated Sep 27, 2022

Key facts

NPI
1972240398
Entity type
Individual (NPI type 1)
Primary specialty
School Psychologist 103TS0200X
License
25942 (WY)
Practice address
615 Hamilton St
Douglas, WY 82633-2615
Phone
(307) 358-6187
NPI assigned
May 17, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LPC-1121WYMDMental Health Counselor
25942WYMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Converse County School District #1 Current
since May 22, 2022
Accepting new patients

Locations

615 Hamilton St
Douglas, WY 82633
Phone (307) 358-2942

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC-1121 WY
School Psychologist 103TS0200X 25942 WY Yes

Addresses

Primary practice location

615 Hamilton St
Douglas, WY 82633-2615

Mailing address

615 Hamilton St
Douglas, WY 82633-2615
Phone (307) 358-6187

Other identifiers

IdentifierTypeStateIssuer
25942OtherWYPROFESSIONAL TEACHING STANDARDS BOARD
LPC-1121OtherWYMENTAL HEALTH PROFESSIONS LICENSING BOARD

Other providers in Douglas, WY

All providers in Douglas, WY · School Psychologist in Wyoming

Sources for this page

Verify at the official NPI Registry.