Provider Demographics
NPI:1013208297
Name:ORTEGA, CAMERON LACY (LPC)
Entity Type:Individual
Prefix:MS
First Name:CAMERON
Middle Name:LACY
Last Name:ORTEGA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5904 N 14 1/2 ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-3406
Mailing Address - Country:US
Mailing Address - Phone:956-453-0053
Mailing Address - Fax:
Practice Address - Street 1:5904 N 14 1/2 ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-3406
Practice Address - Country:US
Practice Address - Phone:956-453-0053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-22
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66645101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health