Healthcare Provider Details

I. General information

NPI: 1639007776
Provider Name (Legal Business Name): AMY CAMPOS LPC-ASSOCIATE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 KIRBY RD
SEABROOK TX
77586-5202
US

IV. Provider business mailing address

9506 EDDYS EDGE CT
HOUSTON TX
77089-2382
US

V. Phone/Fax

Practice location:
  • Phone: 713-527-2295
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number100063
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: