Provider Demographics
NPI:1962712778
Name:MCCAMY, MICHELLE ANN (SW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANN
Last Name:MCCAMY
Suffix:
Gender:
Credentials:SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 S 12TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-5941
Mailing Address - Country:US
Mailing Address - Phone:701-554-2442
Mailing Address - Fax:701-258-5999
Practice Address - Street 1:914 S 12TH ST STE 101
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504-5941
Practice Address - Country:US
Practice Address - Phone:701-554-2442
Practice Address - Fax:701-258-5999
Is Sole Proprietor?:No
Enumeration Date:2010-10-14
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND54521Medicaid