Provider Demographics
NPI:1669161543
Name:LAUREN CAMACHO INTEGRATIVE COUNSELING, A LICENSED CLINICAL SOCIAL WORK
Entity type:Organization
Organization Name:LAUREN CAMACHO INTEGRATIVE COUNSELING, A LICENSED CLINICAL SOCIAL WORK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:CAMACHO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:626-833-8034
Mailing Address - Street 1:749 S OAK TREE DR
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-3614
Mailing Address - Country:US
Mailing Address - Phone:626-833-8034
Mailing Address - Fax:
Practice Address - Street 1:1211 CENTER COURT DR STE 106
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91724-3693
Practice Address - Country:US
Practice Address - Phone:626-833-8034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-05
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty