Provider Demographics
NPI:1851130256
Name:LARUE, CAMERON LEE (LPC)
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:LEE
Last Name:LARUE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 ALEXANDER DR
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-9703
Mailing Address - Country:US
Mailing Address - Phone:830-832-0595
Mailing Address - Fax:
Practice Address - Street 1:148 ALEXANDER DR
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-9703
Practice Address - Country:US
Practice Address - Phone:830-832-0595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89930101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health