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NPI Code Detail

MEDICARE: MR. ANDREW MARC CAMERON LPCC, LADC

MEDICARE: MR. ANDREW MARC CAMERON LPCC, LADC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor306485MN
2101YM0800XMental Health Counselor5443MN

General Provider Information

NPI Number : 1023730827
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANDREW MARC CAMERON LPCC, LADC
Provider Business Mailing Address
First Line : 4620 77TH ST W APT 349
Second Line :
City : EDINA
State : MN
Zip : 55435-2275
Country : US
Telephone Number : 512-825-4569
Fax Number :
Provider Business Practice Location Address
First Line : 5346 LYNDALE AVE S
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55419-1230
Country : US
Telephone Number : 651-365-8212
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2022
Last Update Date : 02/02/2026

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