Lacy Middlebrooks Camp, M. ED.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

000478 Issued in GA

Practice address

1690 S Milledge Ave
Athens, GA 30605-1453

Phone

(706) 369-7911

Fax

(706) 208-9509

NPI assigned

May 15, 2007

Last updated

Oct 7, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Athens Pastoral Counseling Dba Samaritan Counseling Center

  • Professional Counselor
  • Athens, GA
  • NPI 1285732784
  NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223337600000",
    "number": "1982810867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 N LUMPKIN ST",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306012744",
            "telephone_number": "706-369-7911",
            "fax_number": "706-208-9509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 S MILLEDGE AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306051453",
            "telephone_number": "706-369-7911",
            "fax_number": "706-208-9509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMP",
        "first_name": "LACY",
        "middle_name": "MIDDLEBROOKS",
        "name_prefix": "Ms.",
        "credential": "M. ED.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2008-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "000967",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "000478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randal Shane Calvert
• Sidney Lamb Cambardella, PT, DPT
• Megan Camery
• Laura Camilleri, LMSW
• Ashley Toomer Camoosa, PTA
• Cassie Nicol Campbell, MD
• David Campbell, PHD
• Dorothy Campbell, LPN
• Hailey S Campbell, APRN, FNP-BC
• Kathleen Campbell, LMSW

• Marriage & Family Therapist in Athens, GA
• Providers in Athens, GA by specialty
• Marriage & Family Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; 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.