CAMELOT COMMUNITY CARE, INC (NPI# 1629205646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629205646 |
| Entity Type | Organization |
| Organization Name | CAMELOT COMMUNITY CARE, INC |
| Practice Address |
1524 S Ih 35 Suite 218 Austin TX 78704-8931 |
| Mailing Address |
4910 Creekside Dr Ste D Clearwater FL 33760-4034 |
| Practice Telephone | 5124440900 |
| Practice Fax Number | 5124440901 |
| Mailing Telephone | 7275930003 |
| Mailing Fax Number | 7273690379 |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2009-06-17 |
| Authorized Official Name | MICHAEL DIBRIZZI (CEO) |
| Authorized Official Telephone | 7275930003 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619225679 | Camelot Community Care, Inc | Foster Care Agency | 1412 Tech Blvd, Tampa, FL 33619-7865 | 2012-08-23 |
| 1316161110 | Camelot Community Care, Inc | Community/Behavioral Health | 1601 Ne 25th Ave, Suite 306, Ocala, FL 34470-8800 | 2007-04-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | CAMELOT COMMUNITY CARE, INC. | 4910-d Creekside Drive, Clearwater, FL 33760 |
| Street Address |
1524 S IH 35 SUITE 218 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78704-8931 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699740712 | Richard Biddle Briggs | Ophthalmology | 1524 S Ih 35, Suite 235, Austin, TX 78704-8931 | 2006-02-22 |
| 1629520978 | Michelle M Wise | Counselor | 1524 S Ih 35, Suite 210, Austin, TX 78704-8931 | 2016-11-02 |
| 1619356458 | Sydney Mcquade | Counselor | 1524 S Ih 35, Suite 202, Austin, TX 78704-8931 | 2015-05-26 |
| 1710389374 | Tonya Hadley | Counselor | 1524 S Ih 35, Suite 210, Austin, TX 78704-8931 | 2014-09-25 |
| 1457764797 | Misty Mathis | Counselor | 1524 S Ih 35, Suite 210, Austin, TX 78704-8931 | 2014-06-04 |
| 1508125444 | Tracy Carver | Psychologist | 1524 S Ih 35, Suite 202, Austin, TX 78704-8931 | 2012-05-13 |
| 1316215635 | Iveth Pacheco | Counselor | 1524 S Ih 35, 210, Austin, TX 78704-8931 | 2011-12-01 |
| 1184906083 | Barbara Lynn Christenson | Counselor | 1524 S Ih 35, Suite 210, Austin, TX 78704-8931 | 2011-09-15 |
| 1851697692 | Terisa Ann Marini | Social Worker | 1524 S Ih 35, Suite 210, Austin, TX 78704-8931 | 2011-01-26 |
| 1699947937 | Johanna Louise Gravesmill | Social Worker | 1524 S Ih 35, Suite 210, Austin, TX 78704-8931 | 2008-03-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801494018 | 340b Partners Pharmacy - Dallas LLC | Pharmacy | 2800 S Ih 35 Frontage Rd, Suite 105, Austin, TX 78704 | 2020-10-12 |
| 1740802206 | Roots, Aba Therapy and Consulting Services LLC | Behavioral Analyst | 3715 S. 1st St, #464, Austin, TX 78704 | 2020-05-07 |
| 1447896071 | Stefanie Van Hoose Mott | Nurse Practitioner | 2800 South Ih 35 Frontage Road #100, Austin, TX 78704 | 2019-11-19 |
| 1902463219 | Melanie Rabalais Lpc, Pllc | Counselor | 3111 Dickson Dr, Suite 33, Austin, TX 78704 | 2019-05-22 |
| 1023590866 | Roberto Carlos Guerra | Physical Therapy Assistant | 2515 S Ih 35, Ste 320, Austin, TX 78704 | 2018-08-29 |
| 1750875118 | Kristen Gabrielle Ferrante | Dentist | 2330 S Lamar Blvd, Austin, TX 78704 | 2018-06-19 |
| 1366944555 | Beryl Hoelscher | Registered Nurse | 706 W Ben White Blvd Ste 233a, Austin, TX 78704 | 2018-03-02 |
| 1780103861 | Remedy Pediatrics Pllc | Pediatrics | 2512 South Interstate 35 Frontage Rd., Suite 310, Austin, TX 78704 | 2017-09-11 |
| 1285176172 | Leah Nichole Burandt | Physician Assistant | 2512 S Interstate 35 Ste 310, Austin, TX 78704 | 2016-11-09 |
| 1659822690 | Kristin Jarrett | Physical Therapist | 1524 S I-35, Suite 300, Austin, TX 78704 | 2016-10-14 |
| Find all providers in zip 78704 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407457385 | Rachel Marie Trembley | Counselor | 10403 School House Ln, Austin, TX 78750-1728 | 2020-11-05 |
| 1619578614 | Naquasha Riser | Counselor | 9415 Mcneil Dr Apt 623, Austin, TX 78750-8560 | 2020-11-05 |
| 1811596372 | Alexandra Caron | Counselor | 11900 Hobby Horse Ct Apt 434, Austin, TX 78758-2953 | 2020-10-25 |
| 1003415068 | Thomas Craig Saathoff | Counselor | 1616 Headway Cir, Austin, TX 78754-5106 | 2020-10-21 |
| 1699373746 | Molly Roth | Counselor | 7703 N Lamar Blvd Ste 500, Austin, TX 78752-1055 | 2020-10-12 |
| 1063010098 | Lindsey Witz | Counselor | 2525 Wallingwood Dr Ste 301, Austin, TX 78746-6922 | 2020-10-12 |
| 1396350823 | Natalie Hussung Schneider | Counselor | 7703 N Lamar Blvd Ste 340, Austin, TX 78752-1061 | 2020-09-11 |
| 1174135818 | Melanie Dyer | Counselor | 401 Little Texas Ln Apt 1526, Austin, TX 78745-4135 | 2020-08-22 |
| 1366053563 | Selena E Coburn | Counselor | 4424 Gaines Ranch Loop Apt 1434, Austin, TX 78735-6540 | 2020-08-11 |
| 1235748674 | Paz Behavioral Health, Pllc | Counselor | 3310 W Braker Ln Ste 300545, Austin, TX 78758-7853 | 2020-07-30 |
| Find all providers in AUSTIN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.