Provider Demographics
NPI:1124642798
Name:CAMERON, ERIN (LPC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:CAMERON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7925 S BROADWAY AVE STE 440
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-5297
Mailing Address - Country:US
Mailing Address - Phone:903-705-6337
Mailing Address - Fax:903-705-6532
Practice Address - Street 1:7925 S BROADWAY AVE STE 440
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-5297
Practice Address - Country:US
Practice Address - Phone:903-705-6337
Practice Address - Fax:903-705-6532
Is Sole Proprietor?:No
Enumeration Date:2020-05-29
Last Update Date:2023-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
TX78744101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health