MEDICARE: CAMERIN RAPIER CDCA, QMHS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	CDCA.188884	OH

General Provider Information

NPI Number	:	1538964424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMERIN RAPIER CDCA, QMHS

Provider Business Mailing Address
First Line	:	371 W 1ST ST
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45402-3012
Country	:	US
Telephone Number	:	937-251-7068
Fax Number	:

Provider Business Practice Location Address
First Line	:	371 W 1ST ST
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45402-3012
Country	:	US
Telephone Number	:	937-251-7068
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2025
Last Update Date	:	02/15/2025

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