Provider Demographics
NPI:1730338989
Name:LERMINEZ, CAMERON (PSYD)
Entity type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:
Last Name:LERMINEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:CAMERON
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:2221 52ND AVE
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-6371
Mailing Address - Country:US
Mailing Address - Phone:309-323-0207
Mailing Address - Fax:
Practice Address - Street 1:2221 52ND AVE
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-6371
Practice Address - Country:US
Practice Address - Phone:309-323-0207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-11
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA128920101YM0800X
IL180017491101YP2500X
MO2011004622103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1730338989Medicaid