Provider Demographics
NPI:1326314550
Name:CAMPOS, JESUS ARTURO (LPC)
Entity Type:Individual
Prefix:
First Name:JESUS
Middle Name:ARTURO
Last Name:CAMPOS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6455 HILLER ST STE A4
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-1057
Mailing Address - Country:US
Mailing Address - Phone:915-407-5448
Mailing Address - Fax:877-300-2730
Practice Address - Street 1:6455 HILLER ST STE A4
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-1057
Practice Address - Country:US
Practice Address - Phone:915-407-5448
Practice Address - Fax:877-300-2730
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-02
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
TX75720101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst