TIMOTHY LEE CAMMACK (NPI# 1972554111) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972554111 |
| Entity Type | Individual |
| Full Name | TIMOTHY LEE CAMMACK |
| Credential | LICSW |
| Practice Address |
3915 Golden Valley Road Courage Center Golden Valley MN 55422-4298 |
| Practice Telephone | 7635200645 |
| Practice Fax Number | 7635200355 |
| Mailing Telephone | 7635200645 |
| Mailing Fax Number | 7635200355 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
06687 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UBH | 6236582 | 01 | |
| BCBS MINNESOTA | 89D34CA | 01 | |
| HEALTH PARTNERS | HP23150 | 01 | |
| MEDICA | 6236582 | 01 | |
| PREFERRED ONE | 963371012571 | 01 |
| Street Address |
3915 GOLDEN VALLEY ROAD COURAGE CENTER |
| City | GOLDEN VALLEY |
| State | MN |
| Zip Code | 55422-4298 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316903172 | Sarah Elizabeth Mutch Hinck | Physical Therapist | 3915 Golden Valley Road, Courage Center, Golden Valley, MN 55422-4298 | 2006-04-21 |
| 1811150998 | Jeanine M. Gray | Physical Therapy Assistant | 3915 Golden Valley Road, Courage Center, Golden Valley, MN 55422 | 2008-07-08 |
| 1619134574 | Mark Huttemier | Psychologist | 3915 Golden Valley Road, Courage Center, Golden Valley, MN 55422 | 2008-05-19 |
| 1386760288 | Susan A Redepenning | Occupational Therapist | 3915 Golden Valley Road, Courage Center, Golden Valley, MN 55422-4298 | 2007-03-22 |
| 1962535245 | Jodi Lynn Dezale | Speech-Language Pathologist | 3915 Golden Valley Road, Courage Center, Golden Valley, MN 55422-4298 | 2007-03-14 |
| 1356495154 | Shawn C Cole | Occupational Therapy Assistant | 3915 Golden Valley Road, Courage Center, Golden Valley, MN 55422-4298 | 2007-01-22 |
| 1780744110 | Whitney K Hanson | Speech-Language Pathologist | 3915 Golden Valley Road, Courage Center, Golden Valley, MN 55422-4298 | 2006-12-08 |
| 1578634903 | Carmen Bradbury | Occupational Therapist | 3915 Golden Valley Road, Courage Center, Golden Valley, MN 55422-4298 | 2006-11-09 |
| 1811070071 | Shannon Marie Leppi | Speech-Language Pathologist | 3915 Golden Valley Road, Courage Center, Golden Valley, MN 55422-4298 | 2006-10-23 |
| 1215024534 | Jennifer L Kahn | Social Worker | 3915 Golden Valley Road, Courage Center, Golden Valley, MN 55422-4298 | 2006-10-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154966794 | Trevor Velin | Chiropractor | Robin Center Chiropractic, Pa, 4080 W Broadway Ave, 310, Robbinsdale, MN 55422 | 2019-11-07 |
| 1780165134 | American Current Care of Minnesota PC | Clinic/Center | 4080 W Broadway Ave Ste 200, Robbinsdale, MN 55422 | 2018-08-23 |
| 1366928426 | Creekside Family Dental Pllc | Dentist | Giebenhain Dental Associates, P.a., 5851 Duluth Street # 103, Golden Valley, MN 55422 | 2018-07-12 |
| 1497249536 | Luke Utecht | Psychologist | 4150 Olson Memorial Hwy, Suite 420, Golden Valley, MN 55422 | 2018-06-21 |
| 1821582115 | Ajaa Oliver | Registered Nurse | 3606 Zenith Ave N, Robbinsdale, MN 55422 | 2018-06-19 |
| 1306348024 | Leila Jean Erlandson | Marriage & Family Therapist | Golden Valley Executive Center, 4284 Dahlberg Drive, Golden Valley, MN 55422 | 2018-03-08 |
| 1467969907 | Minneapolis Health Clinic Pllc | Internal Medicine | 4825 Olson Memorial Hwy., Suite 101, Golden Valley, MN 55422 | 2018-01-05 |
| 1275049116 | Lake Town Homecare, LLC | In Home Supportive Care | 4119 Scott Ave N, Robbinsdale, MN 55422 | 2017-12-14 |
| 1750894002 | Unihealth Home Care, LLC | Home Health | 1710 Douglas Dr N Ste 226j, Golden Valley, MN 55422 | 2017-11-08 |
| 1194172296 | Crosscultural Health Care Inc | Home Health | 5801 Duluth Street Suite 310, Golden Valley, MN 55422 | 2016-05-18 |
| Find all providers in zip 55422 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134640477 | Koski Stark Ghodge LLC | Social Worker | 8014 Highway 55 # 515, Golden Valley, MN 55427-4712 | 2017-06-27 |
| 1215393483 | Branden David Phillips | Social Worker | 3241 Scott Ave N, Golden Valley, MN 55422-2745 | 2016-01-04 |
| 1477954709 | David Williams | Social Worker | 830 Boone Ave N, Golden Valley, MN 55427-4568 | 2014-09-05 |
| 1346678836 | Ernest Smith | Social Worker | 8401 Wayzata Blve, Suite 370, Golden Valley, MN 55426-1379 | 2013-10-22 |
| 1801135223 | Comfort Belbas | Social Worker | 6100 Golden Valley Rd, Golden Valley, MN 55422-4442 | 2013-02-05 |
| 1619132099 | Lori Ann Mitchell | Social Worker | 1405 Lilac Dr N Ste 151, Golden Valley, MN 55422-4536 | 2008-07-24 |
| 1730377698 | David Taylor Smith | Social Worker | 7215 Glenwood Ave, Golden Valley, MN 55427-4806 | 2007-10-04 |
| 1275731440 | Stephanie Ann Beckley | Social Worker | 701 Decatur Avenue North, Suite 109, Golden Valley, MN 55427 | 2007-07-10 |
| 1417089616 | Constance Joan Schweigert | Social Worker | 8421 Wayzata Blvd Ste 140, Golden Valley, MN 55426-1393 | 2007-03-12 |
| 1184772246 | Elizabeth Eileen Nager | Social Worker | 8100 Wayzata Blvd, Golden Valley, MN 55426-1338 | 2007-01-08 |
| Find all providers in GOLDEN VALLEY | ||||
| City | GOLDEN VALLEY |
| Zip Code | 55422 |
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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.