Deirdre L Camacho-Russell, MSP, LBS

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BH007172 Issued in PA

Practice address

1329 N 56TH St
Philadelphia, PA 19131-4225

Phone

(215) 251-9139

NPI assigned

May 24, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1400889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1760894752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 6TH ST",
            "city": "ATCO",
            "state": "NJ",
            "postal_code": "080041113",
            "telephone_number": "215-251-9139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 N 56TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191314225",
            "telephone_number": "215-251-9139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMACHO-RUSSELL",
        "first_name": "DEIRDRE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "MSP, LBS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-24",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "BH007172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carmela Valentina Calvo, MD
• Evan Michael Calvo
• Yoel Calzada-Sanchez
• Eric Z Cam, DO
• Kristin M Cam, MD
• David Camacho, MD
• Michael Jorge Camacho
• Fatim Camara
• Yvette Camara
• Ruby J. Camarena, MD

• Behavior Analyst in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Behavior Analyst in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.