MEDICARE: ERIN CAMERON LPC

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	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor	78744	TX

General Provider Information

NPI Number	:	1124642798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN CAMERON LPC

Provider Business Mailing Address
First Line	:	7925 S BROADWAY AVE STE 440
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75703-5297
Country	:	US
Telephone Number	:	903-705-6337
Fax Number	:	903-705-6532

Provider Business Practice Location Address
First Line	:	7925 S BROADWAY AVE STE 440
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75703-5297
Country	:	US
Telephone Number	:	903-705-6337
Fax Number	:	903-705-6532

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

Provider Enumeration Date	:	05/29/2020
Last Update Date	:	10/28/2023

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Directions to “ ERIN CAMERON LPC” Practice Location

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