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1508385568 NPI number — ROSALIE ANN CAMACHO-COLLIER LICSW

NPI Number: 1508385568
Health Care Provider/Practitioner: ROSALIE ANN CAMACHO-COLLIER LICSW

Information about “1508385568” NPI (ROSALIE ANN CAMACHO-COLLIER LICSW) exists in 1508385568 in HTML format HTML  |  1508385568 in plain Text format TXT  |  1508385568 in PDF (Portable Document Format) PDF  |  1508385568 in an XML format XML  formats.

NPI Number : 1508385568 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1508385568",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CAMACHO-COLLIER",
    "FirstName": "ROSALIE",
    "MiddleName": "ANN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LICSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "CAMACHO",
    "OtherFirstName": "ROSALIE",
    "OtherMiddleName": "A",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "LICSW",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "400 E FLOYCE ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "RULEVILLE",
    "MailingAddressStateName": "MS",
    "MailingAddressPostalCode": "38771-3922",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "401-626-7313",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "232 MARKET ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FLOWOOD",
    "PracticeLocationAddressStateName": "MS",
    "PracticeLocationAddressPostalCode": "39232-3339",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "323-205-7088",
    "PracticeLocationAddressFaxNumber": "833-419-0181",
    "EnumerationDate": "09/11/2017",
    "LastUpdateDate": "10/13/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "ISW02926",
          "LicenseNumberStateCode": "RI",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "C11636",
          "LicenseNumberStateCode": "MS",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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