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NPI Code Detail

MEDICARE: CAMRON HINCKLE MS, LPC-IT

MEDICARE: CAMRON HINCKLE MS, LPC-IT
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
1101YM0800XMental Health Counselor2829-226WI

General Provider Information

NPI Number : 1578013488
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAMRON HINCKLE MS, LPC-IT
Provider Business Mailing Address
First Line : 12630 W NORTH AVE
Second Line : BUILDING E
City : BROOKFIELD
State : WI
Zip : 53005-4626
Country : US
Telephone Number : 262-785-1008
Fax Number : 262-432-9259
Provider Business Practice Location Address
First Line : 15850 W BLUEMOUND RD STE 202
Second Line :
City : BROOKFIELD
State : WI
Zip : 53005-6007
Country : US
Telephone Number : 262-200-1282
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2016
Last Update Date : 03/05/2026

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