Provider Demographics
NPI:1609431071
Name:BETANCOURT, CAMILA (LMHC)
Entity Type:Individual
Prefix:
First Name:CAMILA
Middle Name:
Last Name:BETANCOURT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:CAMILA
Other - Middle Name:
Other - Last Name:PEREIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11200 SW 8 ST AHC 1 ROOM 242
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33199-0001
Mailing Address - Country:US
Mailing Address - Phone:305-348-7142
Mailing Address - Fax:
Practice Address - Street 1:11200 SW 8 ST AHC 1 ROOM 242
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33199-0001
Practice Address - Country:US
Practice Address - Phone:305-348-7142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-01
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH16922101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health