Healthcare Provider Details

I. General information

NPI: 1457912370
Provider Name (Legal Business Name): ELIZABETH J CAMERA LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2019
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5204 MAHONING AVE STE 105
YOUNGSTOWN OH
44515-1808
US

IV. Provider business mailing address

5204 MAHONING AVE STE 105
YOUNGSTOWN OH
44515-1808
US

V. Phone/Fax

Practice location:
  • Phone: 330-797-0036
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.2505692
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: