1. Home
  2. Directory
  3. Idaho
  4. Chubbuck
  5. Psychologist
  6. NPI Profile

DR. CAMERON STALEY PSYCHOLOGIST
NPI 1932811163
Psychologist - Clinical in Chubbuck, ID

Active since December 19, 2022Opted out of Medicare · through Oct 15, 2026
5026 CASSIE DR, CHUBBUCK, ID 83202(801) 644-2006 Get Directions Write a Review

NPPES record last updated: April 17, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 17, 2024, Dec 19, 2022 (2 updates tracked since 2022).

About Dr. Cameron Staley Psychologist NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. CAMERON STALEY PSYCHOLOGIST (NPI 1932811163) is an individual clinical provider in Chubbuck, Idaho, licensed in Idaho (PSY202707) and active in the NPI registry since December 2022. He has opted out of Medicare through October 15, 2026.

NPPES Registry Identity

NPI1932811163
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameDR. CAMERON STALEYCredential: PSYCHOLOGIST
Location Address5026 CASSIE DRChubbuck, ID 83202-5252
Mailing Address5026 Cassie DrChubbuck, ID 83202-5252
Phone(801) 644-2006
Sole ProprietorYes
Enumeration DateDecember 19, 2022
Last NPPES UpdateApril 17, 20242 updates tracked since enumeration
NPPES CertifiedApril 17, 2024
✔ NPI 1932811163 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
Licenses✔ Licensed in ID · PSY202707✔ Licensed in UT · 56668202501
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
5026 CASSIE DR, Chubbuck, ID 83202
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Cameron Staley Psychologist has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 15, 2024 through October 15, 2026.

Opt-Out Effective DateOctober 15, 2024
Opt-Out In Effect ThroughOctober 15, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAMERON STALEY PHD LLC
Clinic/Center (Adult Mental Health)
5026 CASSIE DR
CHUBBUCK, ID 83202
Bannock County (801) 644-2006

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Cameron Staley's NPI number?

The NPI number for Cameron Staley is 1932811163. It was assigned to this individual provider in the NPPES registry on December 19, 2022.

Where is Cameron Staley located?

Cameron Staley practices at 5026 Cassie Dr, Chubbuck, ID 83202. The listed phone number is (801) 644-2006.

What is Cameron Staley's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Cameron Staley enrolled in Medicare?

No. Cameron Staley has opted out of Medicare through October 15, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Cameron Staley was last updated on April 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.