Provider Demographics
NPI:1154782563
Name:M.A. CAMP COUNSELING SERVICES, PLLC
Entity type:Organization
Organization Name:M.A. CAMP COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIEANN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMP
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, LCDC
Authorized Official - Phone:254-400-9931
Mailing Address - Street 1:2904 E STAN SCHLUETER LOOP # 38
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-4813
Mailing Address - Country:US
Mailing Address - Phone:254-400-9931
Mailing Address - Fax:866-873-4947
Practice Address - Street 1:100 W CENTRAL TEXAS EXPY STE 310
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-7498
Practice Address - Country:US
Practice Address - Phone:254-400-9931
Practice Address - Fax:866-873-4947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-11
Last Update Date:2016-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11832251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health