Provider Demographics
NPI:1639532195
Name:CAMERON, LEE ANN (LPC)
Entity Type:Individual
Prefix:MS
First Name:LEE
Middle Name:ANN
Last Name:CAMERON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:LEE ANN
Other - Middle Name:ZIMMERS
Other - Last Name:CAMERON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7001 SAINT JOHNS CIR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-1943
Mailing Address - Country:US
Mailing Address - Phone:512-200-5386
Mailing Address - Fax:
Practice Address - Street 1:3625 MANCHACA RD
Practice Address - Street 2:SUITE 102B
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-6631
Practice Address - Country:US
Practice Address - Phone:512-200-5386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-01
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX306834101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional