Provider Demographics
NPI:1326525395
Name:CAMACHO, JULIA (LMSW)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:CAMACHO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 CHARDON MEADOWS DR NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-0531
Mailing Address - Country:US
Mailing Address - Phone:505-264-8830
Mailing Address - Fax:
Practice Address - Street 1:4100 BARBARA LOOP SE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-1000
Practice Address - Country:US
Practice Address - Phone:505-702-8547
Practice Address - Fax:505-702-8604
Is Sole Proprietor?:No
Enumeration Date:2018-07-23
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM010001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical