Individual provider Active NPI

Eartha J Camon, MA, LPC-S

  • Professional Counselor
  • Crowley, TX
National Provider Identifier
1528094810
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
15133 Issued in TX
Practice address
1459 Conley LN
Crowley, TX 76036-1270
Phone
(817) 466-4450
Fax
(817) 423-7706
NPI assigned
Jun 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 15133 TX Primary

Addresses

Primary practice location

1459 Conley LN
Crowley, TX 76036-1270

Mailing address

910 S Crowley Rd Ste 9-348
Crowley, TX 76036-3686
Phone (817) 466-4450

Other identifiers 1

IdentifierTypeStateIssuer
027934101MedicaidTX

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
15133TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Rud Counseling & Psychotherapy PLLC Professional CurrentSince Jul 25, 2021 Accepting new patients
Eartha J Camon Professional Past Accepting new patients

Locations

910 S Crowley Rd
Ste 9348
Crowley, TX 76036

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1528094810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 S CROWLEY RD STE 9-348",
            "city": "CROWLEY",
            "state": "TX",
            "postal_code": "760363686",
            "telephone_number": "817-466-4450",
            "fax_number": "817-423-7706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1459 CONLEY LN",
            "city": "CROWLEY",
            "state": "TX",
            "postal_code": "760361270",
            "telephone_number": "817-466-4450",
            "fax_number": "817-423-7706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMON",
        "first_name": "EARTHA",
        "middle_name": "J",
        "credential": "MA, LPC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "15133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027934101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crowley, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.