Provider Demographics
NPI:1104491232
Name:CAMERON-YANEZ, ELIZABETH ALEXANDRA (MHC-LP)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ALEXANDRA
Last Name:CAMERON-YANEZ
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-1948
Mailing Address - Country:US
Mailing Address - Phone:914-400-4663
Mailing Address - Fax:
Practice Address - Street 1:239 GOLDEN HILL LANE, SUITE 100
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-6441
Practice Address - Country:US
Practice Address - Phone:845-871-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-21
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP121920101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health