Provider Demographics
NPI:1760135057
Name:CAMMALLERI, ABBY DANIELLE
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:DANIELLE
Last Name:CAMMALLERI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:DANIELLE
Other - Last Name:CAMMALLERI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2942 CHENANGO RD
Mailing Address - Street 2:
Mailing Address - City:WAKEMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44889-9759
Mailing Address - Country:US
Mailing Address - Phone:419-705-0106
Mailing Address - Fax:
Practice Address - Street 1:4 E SEMINARY ST
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857-2121
Practice Address - Country:US
Practice Address - Phone:567-424-6003
Practice Address - Fax:855-429-4118
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical