MEDICARE: CAMILLE CAMACHO LPC-A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	98131	TX

General Provider Information

NPI Number	:	1407648850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMILLE CAMACHO LPC-A

Provider Business Mailing Address
First Line	:	5404 EDMONTON AVE
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79924-3406
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5404 EDMONTON AVE
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79924
Country	:	US
Telephone Number	:	254-368-7592
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2025
Last Update Date	:	07/09/2025

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Directions to “ CAMILLE CAMACHO LPC-A” Practice Location

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