Provider Demographics
NPI:1467172833
Name:CAMACHO, EVA M (MA, NCC, LGPC)
Entity Type:Individual
Prefix:MS
First Name:EVA
Middle Name:M
Last Name:CAMACHO
Suffix:
Gender:F
Credentials:MA, NCC, LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 CREST RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-3721
Mailing Address - Country:US
Mailing Address - Phone:703-401-5242
Mailing Address - Fax:
Practice Address - Street 1:1513 CREST RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-3721
Practice Address - Country:US
Practice Address - Phone:703-401-5242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLGPC00699101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional