Provider Demographics
NPI:1396112561
Name:CAMERON, ARCHORAH (LMSW)
Entity type:Individual
Prefix:
First Name:ARCHORAH
Middle Name:
Last Name:CAMERON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8502 PARK OLYMPIA
Mailing Address - Street 2:
Mailing Address - City:UNIVERSAL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78148-3255
Mailing Address - Country:US
Mailing Address - Phone:720-427-9300
Mailing Address - Fax:
Practice Address - Street 1:8502 PARK OLYMPIA
Practice Address - Street 2:
Practice Address - City:UNIVERSAL CITY
Practice Address - State:TX
Practice Address - Zip Code:78148-3255
Practice Address - Country:US
Practice Address - Phone:720-427-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60975104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker