Individual
DR. JACK E CAMILLERI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D.,LPC & LMFT
Contact information
Practice address
28311 N MAIN ST, SUITE 100, DAPHNE, AL 36526-7074
(251) 625-1480
(251) 625-1482
Mailing address
PO BOX 3116, DAPHNE, AL 36526-3116
(251) 625-1480
(251) 625-1482
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
AL626
AL
106H00000X
Marriage & Family Therapist
Primary
LMFT 154
AL
Other
Enumeration date
11/28/2006
Last updated
09/11/2025
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