Provider Demographics
NPI:1952108409
Name:CAMPOS MENTAL HEALTH COUNSELING, PLLC
Entity type:Organization
Organization Name:CAMPOS MENTAL HEALTH COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JULISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPOS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:347-251-2834
Mailing Address - Street 1:636 PLANK RD STE 111
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-4886
Mailing Address - Country:US
Mailing Address - Phone:347-251-2834
Mailing Address - Fax:929-322-9200
Practice Address - Street 1:636 PLANK RD STE 111
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-4886
Practice Address - Country:US
Practice Address - Phone:347-251-2834
Practice Address - Fax:929-322-9200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty