CAMELOT COMMUNITY CARE (NPI# 1679581250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1679581250 |
Entity Type | Organization |
Organization Name | CAMELOT COMMUNITY CARE |
Practice Address |
4910 Creekside Dr Ste D Clearwater FL 33760-4034 |
Practice Telephone | 7275930003 |
Practice Fax Number | 7275950735 |
Mailing Telephone | 7275930003 |
Mailing Fax Number | 7275950735 |
Enumeration Date | 2006-08-03 |
Last Update Date | 2019-01-15 |
Authorized Official Name | MR. MICHAEL DIBRIZZI (CEO) |
Authorized Official Telephone | 7275930003 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
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 | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
N | 253J00000X | Foster Care Agency | Agencies | ||
Y | 251S00000X | Community/Behavioral Health | Agencies |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | 070852600 | 05 | |
FL | 070589600 | 05 | |
FL | 910585900 | 05 | |
FL | 070588800 | 05 | |
OH | 10400 | 05 | |
FL | 070593400 | 05 | |
FL | 070594202 | 05 | |
FL | 070587000 | 05 | |
FL | 070590000 | 05 | |
FL | 070595100 | 05 | |
FL | 070590001 | 05 | |
FL | 070592600 | 05 | |
IN | 200379750 | 05 | |
FL | 070591800 | 05 | |
FL | 070594200 | 05 | |
FL | 070595101 | 05 | |
FL | 761509400 | 05 | |
FL | 911092500 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043568371 | Camelot Community Care | Community/Behavioral Health | 4910 Creekside Dr, Suite D, Clearwater, FL 33760-4023 | 2012-08-16 |
1497387104 | Camelot Community Care | Counselor | 1601 Ne 25th Ave Ste 306, Ocala, FL 34470-4885 | 2020-02-11 |
1639413859 | Camelot Community Care | Community/Behavioral Health | 1925 S Perimeter Rd, Fort Lauderdale, FL 33309-7122 | 2012-11-15 |
1780933861 | Camelot Community Care | Social Worker | 6416 Melaleuca Lane, Greenacres, FL 33464 | 2012-09-05 |
1881942928 | Camelot Community Care | Community/Behavioral Health | 1925 S Perimeter Rd, Suite 120, Fort Lauderdale, FL 33309-7122 | 2012-08-21 |
1063771780 | Camelot Community Care | Case Management | 7162 Reading Rd, Suite 300, Cincinnati, OH 45237-3838 | 2012-05-15 |
1639406093 | Camelot Community Care | Community/Behavioral Health | 1412 Tech Blvd, Tampa, FL 33619-7865 | 2009-11-05 |
1679797492 | Camelot Community Care | Community/Behavioral Health | 1601 Ne 25th Ave, Sutie 306, Ocala, FL 34470-8800 | 2007-04-12 |
1427171594 | Camelot Community Care | Social Worker | 1601 Ne 25th Ave, Sutie 306, Ocala, FL 34470-8800 | 2007-04-06 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Virginia Business Entities | Camelot Community Care Inc. | 4910-D Creekside Drive, Clearwater, Florida 33760 |
Indiana Business Entities | CAMELOT COMMUNITY CARE, INC. | 4910-d Creekside Drive, Clearwater, FL 33760 |
Street Address |
4910 CREEKSIDE DR STE D |
City | CLEARWATER |
State | FL |
Zip Code | 33760-4034 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851930184 | Carole Yount | Counselor | 4910 Creekside Dr Ste D, Clearwater, FL 33760-4034 | 2020-01-03 |
1407215007 | Cynthia Haynes | Counselor | 4910 Creekside Dr Ste D, Clearwater, FL 33760-4034 | 2016-02-11 |
1841547635 | Heather Klinkenberg | Counselor | 4910 Creekside Dr Ste D, Clearwater, FL 33760-4034 | 2012-08-10 |
1265789069 | Jennifer L Kinderdine | Social Worker | 4910 Creekside Dr Ste D, Clearwater, FL 33760-4034 | 2012-08-10 |
1033472949 | Charles Bareishis | Social Worker | 4910 Creekside Dr Ste D, Clearwater, FL 33760-4034 | 2012-06-18 |
1932461357 | Eileen Pashak | Counselor | 4910 Creekside Dr Ste D, Clearwater, FL 33760-4034 | 2012-06-12 |
1831463116 | Nancy Mikhael | Counselor | 4910 Creekside Dr Ste D, Clearwater, FL 33760-4034 | 2012-03-03 |
1992905681 | Catherine Angela Coscia | Counselor | 4910 Creekside Dr Ste D, Clearwater, FL 33760-4034 | 2007-07-20 |
1003947862 | Renee G Haxton | Counselor | 4910 Creekside Dr Ste D, Clearwater, FL 33760-4034 | 2007-03-07 |
1699828608 | Robin Anne Lee | Counselor | 4910 Creekside Dr Ste D, Clearwater, FL 33760-4034 | 2007-01-21 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053813444 | Enver Ruzdija Arnp LLC | Clinic/Center | 14690 Sugar Cane Way, Clearwater, FL 33760 | 2018-03-01 |
1528577087 | Csi-pediatric Services, Inc | Clinic/Center | 5291 110th Ave, Clearwater, FL 33760 | 2017-09-27 |
1457877094 | Healthcare Alliance LLC | In Home Supportive Care | 13575 58 St N, Ste 178, Clearwater, FL 33760 | 2017-08-15 |
1497208805 | 211 Tampa Bay Cares, Inc. | Voluntary or Charitable | 14155 58th Street North, Suite 211, Clearwater, FL 33760 | 2016-08-02 |
1760885503 | Amanda Pawlik | Physical Therapist | 13830 58th St. N., Suite 409, Clearwater, FL 33760 | 2014-10-08 |
1871842252 | Christine Lynne Felix | Radiology | 2028 Arbor Drive, Clearwater, FL 33760 | 2012-08-31 |
1194072017 | Anna Mccord | Speech-Language Pathologist | 13575 58th Street North, Clearwater, FL 33760 | 2012-08-09 |
1245460195 | Patricia Kathrine Clay | Occupational Therapist | 4902 Creekside Dr Ste A, Clearwater, FL 33760 | 2009-07-24 |
1346447992 | Tms Management Group, Inc. | Transportation Broker | 16331 Bay Vista Dr, Clearwater, FL 33760 | 2007-06-28 |
1730266461 | Joan Marie Jannino | Social Worker | 2188 58th St. N., Clearwater, FL 33760 | 2006-11-01 |
Find all providers in zip 33760 |
Taxonomy Code | 251S00000X |
Grouping | Agencies |
Classification | Community/Behavioral Health |
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881161164 | Health Nexus LLC | Community/Behavioral Health | 3118 Gulf To Bay Blvd Ste 226d, Clearwater, FL 33759-4553 | 2018-10-25 |
1013371269 | Tanika Dampier | Community/Behavioral Health | 215 N Saturn Ave, Clearwater, FL 33755-5926 | 2016-04-13 |
1205228251 | Heads | Community/Behavioral Health | 10 S Pegasus Ave, Clearwater, FL 33765-3432 | 2015-02-28 |
1215345061 | Rescare Behavior Services, Inc. | Community/Behavioral Health | 24761 Us Highway 19 N, Clearwater, FL 33763-3933 | 2014-07-24 |
1366855587 | Mindworks On Call | Community/Behavioral Health | 2878 Fair Green Dr, Clearwater, FL 33761-1845 | 2014-06-05 |
1043568371 | Camelot Community Care | Community/Behavioral Health | 4910 Creekside Dr, Suite D, Clearwater, FL 33760-4023 | 2012-08-16 |
1174884134 | Applied Behavior Approaches of Tampa Bay Inc. | Community/Behavioral Health | 2225 Nursery Rd, Apt 13-203, Clearwater, FL 33764 | 2012-06-06 |
1730326141 | House of Mercy & Encouragement | Community/Behavioral Health | 2723 Belle Haven Dr, Clearwater, FL 33763-1002 | 2009-01-07 |
1174785323 | Proactive Behavior Solutions Incorporated | Community/Behavioral Health | 2460 Northside Dr, Apt 1303, Clearwater, FL 33761-2242 | 2008-06-30 |
1225178437 | Abilities Inc of Florida | Community/Behavioral Health | 2735 Whitney Rd, Clearwater, FL 33760-1610 | 2007-02-07 |
Find all providers in CLEARWATER |
City | CLEARWATER |
Zip Code | 33760 |
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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.