MEDICARE: EVELYN CAMPOS 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	90559	TX
2	101YP2500X	Professional Counselor	90559	TX

General Provider Information

NPI Number	:	1518532902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVELYN CAMPOS LPC

Provider Business Mailing Address
First Line	:	6510 POLARIS DR STE 1
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78041-2054
Country	:	US
Telephone Number	:	956-962-4198
Fax Number	:	866-387-1142

Provider Business Practice Location Address
First Line	:	6510 POLARIS DR STE 1
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78041-2054
Country	:	US
Telephone Number	:	956-962-4198
Fax Number	:	866-387-1142

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

Provider Enumeration Date	:	05/26/2021
Last Update Date	:	02/09/2026

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Directions to “ EVELYN CAMPOS LPC” Practice Location

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