Jennifer Brooke Camareno, MFT

Individual provider Active NPI Marriage & Family Therapist · Eagle, ID

NPI 1174876569 · NPPES record last updated Jun 3, 2023

Key facts

NPI
1174876569
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
MFT-8238 (ID)
Practice address
325 E Shore Dr Ste 120
Eagle, ID 83616-6584
Phone
(208) 464-8806
NPI assigned
Oct 22, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LMFT90338CAMDMarriage & Family Therapist
MFT-8238IDMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT90338 CA
Marriage & Family Therapist 106H00000X MFT-8238 ID Yes

Addresses

Primary practice location

325 E Shore Dr Ste 120
Eagle, ID 83616-6584

Mailing address

650 Sierra Madre Villa Ave Ste 110
Pasadena, CA 91107-2000
Phone (626) 351-9616

Other providers in Eagle, ID

All providers in Eagle, ID · Marriage & Family Therapist in Idaho

Sources for this page

Verify at the official NPI Registry.