=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598607236
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARISSA ELENA OCAMPO LPC-A
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/09/2026
-----------------------------------------------------
Last Update Date | 04/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1404 N CORINTH ST STE 308
-----------------------------------------------------
City | CORINTH
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76208-5447
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 940-268-2509
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2309 DUNCAN PERRY RD
-----------------------------------------------------
City | GRAND PRAIRIE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75050-2039
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-505-1728
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 101130
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------