MEDICARE: MARISSA ELENA OCAMPO LPC-A

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	101130	TX

General Provider Information

NPI Number	:	1598607236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISSA ELENA OCAMPO LPC-A

Provider Business Mailing Address
First Line	:	2309 DUNCAN PERRY RD
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75050-2039
Country	:	US
Telephone Number	:	214-505-1728
Fax Number	:

Provider Business Practice Location Address
First Line	:	1404 N CORINTH ST STE 308
Second Line	:
City	:	CORINTH
State	:	TX
Zip	:	76208-5447
Country	:	US
Telephone Number	:	940-268-2509
Fax Number	:

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

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/09/2026

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Directions to “ MARISSA ELENA OCAMPO LPC-A” Practice Location

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